NPI: 1386154417 · PORTAGE, WI 53901 · Rural Health Clinic/Center · NPI assigned 10/03/2017
Authorized official YANG, JERRY controls 20+ related entities in our dataset. Read more
| Authorized Official | YANG, JERRY (SVP & CHIEF FINANCIAL OFFICER) |
| Parent Organization | DIVINE SAVIOR HEALTHCARE, INC. |
| NPI Enumeration Date | 10/03/2017 |
Other providers sharing the same authorized official: YANG, JERRY
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 195 | $0.00 |
| 2019 | 835 | $37K |
| 2020 | 988 | $48K |
| 2021 | 4,578 | $131K |
| 2022 | 4,844 | $162K |
| 2023 | 4,564 | $158K |
| 2024 | 4,104 | $181K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 6,456 | 5,722 | $316K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8,689 | 7,593 | $285K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 524 | 477 | $31K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 450 | 437 | $26K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1,263 | 1,128 | $14K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 144 | 141 | $8K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 281 | 253 | $7K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 144 | 137 | $6K |
| 99215 | Prolong outpt/office vis | 72 | 72 | $5K |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 63 | 60 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 39 | 39 | $2K |
| 0012A | 62 | 61 | $2K | |
| 90686 | 231 | 222 | $2K | |
| 99307 | 50 | 47 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 90 | 80 | $2K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 117 | 110 | $1K |
| 90670 | 228 | 222 | $965.95 | |
| 99000 | 188 | 167 | $623.49 | |
| Q3014 | Telehealth originating site facility fee | 79 | 72 | $550.64 |
| 0011A | 14 | 14 | $534.24 | |
| 98926 | 16 | 13 | $467.12 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 18 | 15 | $432.42 |
| 90723 | 100 | 98 | $321.41 | |
| 90633 | 25 | 25 | $220.02 | |
| 90647 | 61 | 58 | $188.67 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 14 | 14 | $0.00 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 14 | 12 | $0.00 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 676 | 636 | $0.00 |