NPI: 1285606178 · FOND DU LAC, WI 54935 · 251K00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 7,546 | $144K |
| 2019 | 6,949 | $136K |
| 2020 | 2,325 | $46K |
| 2021 | 2,551 | $45K |
| 2022 | 3,291 | $95K |
| 2023 | 4,169 | $114K |
| 2024 | 4,329 | $131K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | 1,544 | 842 | $117K | |
| D1206 | 6,837 | 6,601 | $98K | |
| H1003 | Prenatal at risk education | 1,777 | 1,430 | $66K |
| D1120 | 2,516 | 2,457 | $64K | |
| D0191 | 4,758 | 4,654 | $57K | |
| D0120 | 2,764 | 2,683 | $48K | |
| D1110 | 1,202 | 1,175 | $37K | |
| T1016 | Case management | 1,598 | 1,446 | $31K |
| H1004 | Follow up home visit/prental | 822 | 745 | $27K |
| D7140 | 585 | 343 | $27K | |
| D2393 | 168 | 103 | $20K | |
| D2930 | 130 | 26 | $17K | |
| D0272 | 964 | 931 | $15K | |
| D2391 | 280 | 180 | $14K | |
| D0140 | 759 | 729 | $14K | |
| D0274 | 712 | 691 | $13K | |
| D0150 | 430 | 407 | $10K | |
| D0330 | 121 | 118 | $5K | |
| D1351 | 297 | 94 | $5K | |
| H1010 | Nonmed family planning ed | 94 | 83 | $4K |
| 99211 | 700 | 430 | $4K | |
| D0220 | 532 | 518 | $4K | |
| 83655 | 576 | 316 | $4K | |
| T1013 | Sign lang/oral interpreter | 125 | 113 | $3K |
| 90686 | 88 | 77 | $1K | |
| D7210 | 14 | 13 | $1K | |
| 36416 | 465 | 249 | $668.01 | |
| H1002 | Carecoordination prenatal | 13 | 13 | $634.27 |
| H1000 | Prenatal care atrisk assessm | 13 | 13 | $525.20 |
| 87591 | 20 | 17 | $490.00 | |
| 87491 | 20 | 17 | $490.00 | |
| D0230 | 79 | 73 | $434.14 | |
| D0240 | 24 | 14 | $220.50 | |
| S4993 | Contraceptive pills for bc | 31 | 27 | $139.77 |
| A4267 | Male condom | 44 | 39 | $128.18 |
| 99000 | 42 | 37 | $123.60 | |
| A4268 | Female condom | 16 | 14 | $36.00 |