STATE OF NEBRASKA DEPT OF ADMIN SERVICES
NPI: 1114085826
· BEATRICE, NE 68310
· 261QA1903X
$129.94
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
79 |
$57.09 |
| 2019 |
77 |
$0.00 |
| 2020 |
57 |
$0.00 |
| 2021 |
44 |
$0.00 |
| 2022 |
59 |
$35.90 |
| 2023 |
44 |
$36.95 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
323 |
323 |
$82.26 |
| 90694 |
|
37 |
37 |
$47.68 |