NPI: 1629145008 · HAVRE, MT 59501 · 251B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 385 | $6K |
| 2019 | 209 | $3K |
| 2020 | 118 | $2K |
| 2021 | 128 | $1K |
| 2022 | 143 | $1K |
| 2023 | 194 | $887.06 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90471 | 533 | 519 | $10K | |
| 90472 | 81 | 71 | $1K | |
| S4993 | Contraceptive pills for bc | 68 | 50 | $686.68 |
| 90734 | 12 | 12 | $669.18 | |
| 90688 | 270 | 262 | $340.00 | |
| 90480 | 14 | 14 | $170.56 | |
| 0134A | 23 | 23 | $127.92 | |
| 90687 | 20 | 20 | $52.74 | |
| 99203 | 30 | 30 | $0.00 | |
| 91313 | 23 | 23 | $0.00 | |
| G0008 | Admin influenza virus vac | 16 | 16 | $0.00 |
| 86592 | 29 | 29 | $0.00 | |
| 86803 | 29 | 29 | $0.00 | |
| 87390 | 29 | 29 | $0.00 |