NPI: 1306163431 · INDIANAPOLIS, IN 46202 · 261QA1903X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 373 | $158K |
| 2019 | 450 | $193K |
| 2020 | 217 | $108K |
| 2021 | 294 | $127K |
| 2022 | 208 | $91K |
| 2023 | 357 | $177K |
| 2024 | 867 | $202K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 41899 | 1,210 | 1,069 | $601K | |
| G0330 | Facility svs dental rehab | 189 | 164 | $172K |
| 43239 | 286 | 250 | $116K | |
| 69436 | 145 | 84 | $61K | |
| 54300 | 96 | 89 | $39K | |
| 17999 | 26 | 17 | $24K | |
| 54304 | 25 | 24 | $23K | |
| 54161 | 46 | 42 | $8K | |
| 67311 | 14 | 13 | $8K | |
| 54163 | 12 | 12 | $2K | |
| 14040 | 13 | 12 | $886.56 | |
| D1206 | 41 | 41 | $0.00 | |
| D7140 | 197 | 38 | $0.00 | |
| 82657 | 52 | 29 | $0.00 | |
| L8699 | Prosthetic implant nos | 48 | 38 | $0.00 |
| 88305 | 14 | 14 | $0.00 | |
| D2933 | 311 | 50 | $0.00 | |
| D1120 | 41 | 41 | $0.00 |