NPI: 1124377460 · HOLDENVILLE, OK 74848 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI assigned 08/31/2012
| Authorized Official | TANNENBAUM, JEREOME (ADMINISTRATOR) |
| NPI Enumeration Date | 08/31/2012 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 129 | $1K |
| 2022 | 263 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90999 | Unlisted dialysis procedure, inpatient or outpatient | 392 | 50 | $7K |