NPI: 1548369317 · BOURBONNAIS, IL 60914 · 208000000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,421 | $35K |
| 2019 | 2,069 | $50K |
| 2020 | 1,171 | $35K |
| 2021 | 797 | $35K |
| 2022 | 1,000 | $50K |
| 2023 | 1,050 | $43K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | 2,129 | 1,673 | $93K | |
| 99214 | 1,379 | 1,008 | $89K | |
| 87428 | 216 | 182 | $13K | |
| 96110 | 743 | 596 | $12K | |
| 87880 | 558 | 450 | $8K | |
| 87804 | 539 | 400 | $8K | |
| 99393 | 102 | 92 | $8K | |
| 90686 | 344 | 294 | $3K | |
| 96372 | 343 | 200 | $3K | |
| 99392 | 36 | 28 | $3K | |
| 99394 | 32 | 31 | $3K | |
| 87807 | 223 | 163 | $2K | |
| 99391 | 22 | 12 | $2K | |
| 94640 | 76 | 36 | $1K | |
| J0696 | Ceftriaxone sodium injection | 236 | 154 | $396.14 |
| 90734 | 12 | 12 | $200.52 | |
| J1100 | Dexamethasone sodium phos | 354 | 205 | $198.69 |
| J7626 | Budesonide non-comp unit | 56 | 24 | $119.49 |
| J7613 | Albuterol non-comp unit | 63 | 29 | $7.93 |
| 90471 | 45 | 33 | $0.00 |