4TH CORPORAITON
NPI: 1295335495
· NEW ROCKFORD, ND 58356
· Community/Behavioral Health Agency
· NPI assigned 10/27/2020
$1.54M
Total Medicaid Paid
Provider Details
| Authorized Official | KELLER, KODI (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 10/27/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
920 |
$410K |
| 2019 |
1,016 |
$368K |
| 2020 |
642 |
$297K |
| 2021 |
1,672 |
$226K |
| 2022 |
1,171 |
$138K |
| 2023 |
926 |
$104K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| W0715 |
|
2,269 |
439 |
$950K |
| T2021 |
Day habilitation, waiver; per 15 minutes |
3,769 |
208 |
$468K |
| W0200 |
|
54 |
48 |
$121K |
| W0700 |
|
255 |
73 |
$4K |