NPI: 1386071678 · MINNETONKA, MN 55343 · 363LF0000X
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 141 | $450.45 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99308 | 12 | 12 | $450.45 | |
| 1123F | 19 | 19 | $0.00 | |
| G9512 | Indiv pdc > 0.8 | 19 | 19 | $0.00 |
| G8433 | Scr for dep not cpt doc rsn | 15 | 15 | $0.00 |
| G8734 | Doc neg eld req | 19 | 19 | $0.00 |
| G8427 | Docrev cur meds by elig clin | 20 | 20 | $0.00 |
| G9916 | Funct status past 12 months | 19 | 19 | $0.00 |
| 4322F | 18 | 18 | $0.00 |