NPI: 1366563314 · FOND DU LAC, WI 54937 · Exclusive Provider Organization · NPI assigned 04/03/2007
| Authorized Official | MICKLE, KIM (COMPLIANCE MANAGER) |
| NPI Enumeration Date | 04/03/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 96,733 | $24.69M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1017 | Targeted case management, each 15 minutes | 90,886 | 54,214 | $23.94M |
| T2003 | Non-emergency transportation; encounter/trip | 1,208 | 1,128 | $388K |
| A0110 | Non-emergency transportation and bus, intra or inter state carrier | 4,155 | 3,849 | $340K |
| S0215 | Non-emergency transportation; mileage, per mile | 422 | 388 | $24K |
| A0170 | Transportation ancillary: parking fees, tolls, other | 62 | 59 | $137.25 |