NPI: 1174116669 · MONDOVI, WI 54755 · Rural Health Clinic/Center · NPI assigned 02/16/2021
Authorized official BORTNEM, MARK controls 20+ related entities in our dataset. Read more
| Authorized Official | BORTNEM, MARK (CFO) |
| NPI Enumeration Date | 02/16/2021 |
Other providers sharing the same authorized official: BORTNEM, MARK
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 179 | $5K |
| 2022 | 723 | $34K |
| 2023 | 745 | $36K |
| 2024 | 287 | $16K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 909 | 846 | $57K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 840 | 742 | $27K |
| 99215 | Prolong outpt/office vis | 73 | 70 | $5K |
| 0004A | 15 | 15 | $534.24 | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 12 | 12 | $503.49 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 41 | 37 | $44.70 |
| 91300 | 31 | 31 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 13 | 13 | $0.00 |