NPI: 1487669388 · WAUKESHA, WI 53189 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 27 | $404.50 |
| 2019 | 27 | $528.20 |
| 2020 | 134 | $2K |
| 2021 | 2,538 | $45K |
| 2022 | 591 | $9K |
| 2023 | 105 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0001A | 499 | 496 | $19K | |
| 0002A | 464 | 455 | $17K | |
| 90686 | 239 | 180 | $5K | |
| 90674 | 128 | 128 | $5K | |
| 0012A | 88 | 84 | $3K | |
| 0011A | 113 | 101 | $3K | |
| 91320 | 28 | 23 | $3K | |
| 0124A | 69 | 69 | $2K | |
| 0004A | 42 | 42 | $2K | |
| 0072A | 35 | 35 | $1K | |
| 0071A | 28 | 28 | $1K | |
| A4627 | Spacer bag/reservoir | 95 | 83 | $938.00 |
| 0054A | 17 | 17 | $648.72 | |
| 91305 | 102 | 99 | $0.00 | |
| 91307 | 95 | 86 | $0.00 | |
| 91301 | 208 | 184 | $0.00 | |
| 91300 | 1,103 | 1,011 | $0.00 | |
| 91312 | 69 | 69 | $0.00 |