NPI: 1073116950 · RICHLAND CENTER, WI 53581 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 1,117 | $16K |
| 2022 | 710 | $23K |
| 2023 | 337 | $16K |
| 2024 | 912 | $20K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99606 | 639 | 547 | $29K | |
| S9430 | Pharmacy comp/disp serv | 438 | 427 | $11K |
| 0001A | 252 | 219 | $7K | |
| 0002A | 173 | 167 | $6K | |
| 99605 | 93 | 84 | $5K | |
| A9150 | Misc/exper non-prescript dru | 333 | 327 | $4K |
| 90679 | 26 | 19 | $3K | |
| 90686 | 124 | 112 | $3K | |
| 90750 | 18 | 14 | $2K | |
| 0134A | 59 | 43 | $2K | |
| 0003A | 64 | 61 | $2K | |
| 0124A | 44 | 43 | $1K | |
| 0004A | 29 | 29 | $1K | |
| 91300 | 634 | 524 | $0.00 | |
| 91312 | 44 | 43 | $0.00 | |
| 91313 | 59 | 43 | $0.00 | |
| 91307 | 21 | 13 | $0.00 | |
| 99607 | 12 | 12 | $0.00 | |
| 91301 | 14 | 12 | $0.00 |