WAGONER MEDICAL GROUP PC
NPI: 1013964162
· GRAND ISLAND, NE 68803
· Nephrology Physician
· NPI assigned 05/27/2006
$479.78
Total Medicaid Paid
Provider Details
| Authorized Official | HUGHES, JODY (OFFICE MANAGER) |
| NPI Enumeration Date | 05/27/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
95 |
$448.14 |
| 2019 |
12 |
$31.64 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90961 |
|
26 |
26 |
$330.56 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
14 |
$90.14 |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
37 |
37 |
$31.64 |
| 80069 |
|
13 |
12 |
$21.44 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
13 |
$6.00 |