NPI: 1538497797 · KENOSHA, WI 53143 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 40 | $1K |
| 2019 | 46 | $1K |
| 2020 | 34 | $490.95 |
| 2021 | 1,971 | $36K |
| 2022 | 523 | $8K |
| 2023 | 107 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0001A | 494 | 482 | $17K | |
| 0002A | 408 | 399 | $15K | |
| 91320 | 56 | 47 | $6K | |
| 90686 | 206 | 188 | $6K | |
| 0004A | 107 | 107 | $4K | |
| 90674 | 93 | 93 | $3K | |
| 0124A | 60 | 60 | $2K | |
| 0054A | 33 | 33 | $1K | |
| 0052A | 16 | 16 | $610.56 | |
| A4627 | Spacer bag/reservoir | 12 | 12 | $187.00 |
| 91305 | 172 | 167 | $0.00 | |
| 91312 | 60 | 60 | $0.00 | |
| 91300 | 1,004 | 915 | $0.00 |