CORRIDOR KETAMINE LLC
NPI: 1356099154
· CORALVILLE, IA 52241
· Family Nurse Practitioner
· NPI assigned 03/11/2022
$979K
Total Medicaid Paid
Provider Details
| Authorized Official | SASSMAN, JENNIFER (ARNP/CREDENTIALING) |
| NPI Enumeration Date | 03/11/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
776 |
$250K |
| 2024 |
1,866 |
$729K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0013 |
Esketamine, nasal spray, 1 mg |
797 |
414 |
$799K |
| 99417 |
Prolong home eval add 15m |
848 |
442 |
$102K |
| 99215 |
Prolong outpt/office vis |
997 |
495 |
$78K |