NPI: 1164553160 · DEVILS LAKE, ND 58301 · 251K00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,516 | $85K |
| 2019 | 3,370 | $71K |
| 2020 | 2,141 | $56K |
| 2021 | 2,719 | $60K |
| 2022 | 1,648 | $45K |
| 2023 | 2,007 | $59K |
| 2024 | 937 | $21K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0302 | Completed epsdt | 1,995 | 1,643 | $212K |
| 90471 | 4,456 | 4,348 | $75K | |
| 90472 | 2,587 | 1,381 | $40K | |
| 96110 | 1,540 | 1,501 | $16K | |
| 90686 | 1,950 | 1,903 | $11K | |
| T1002 | Rn services up to 15 minutes | 922 | 894 | $11K |
| 92567 | 418 | 415 | $6K | |
| D1206 | 154 | 151 | $4K | |
| 91322 | 32 | 31 | $3K | |
| 0001A | 152 | 150 | $3K | |
| 90651 | 236 | 230 | $3K | |
| 99188 | 91 | 90 | $2K | |
| 90662 | 60 | 53 | $2K | |
| 91320 | 47 | 43 | $2K | |
| 0002A | 121 | 118 | $2K | |
| 90656 | 175 | 175 | $2K | |
| 90480 | 108 | 103 | $2K | |
| 0012A | 64 | 56 | $1K | |
| 0011A | 72 | 65 | $1K | |
| 36416 | 45 | 44 | $316.62 | |
| 90715 | 43 | 43 | $312.98 | |
| 0064A | 16 | 13 | $310.68 | |
| 90707 | 13 | 13 | $284.14 | |
| 90670 | 54 | 53 | $205.11 | |
| 90620 | 73 | 70 | $160.75 | |
| 90688 | 40 | 40 | $71.36 | |
| 91301 | 200 | 174 | $0.00 | |
| G0008 | Admin influenza virus vac | 40 | 40 | $0.00 |
| 90696 | 13 | 13 | $0.00 | |
| 91307 | 15 | 15 | $0.00 | |
| 91300 | 381 | 320 | $0.00 | |
| 90734 | 131 | 127 | $0.00 | |
| 90633 | 26 | 26 | $0.00 | |
| 90621 | 12 | 12 | $0.00 | |
| 90685 | 44 | 44 | $0.00 | |
| 90710 | 12 | 12 | $0.00 |