NPI: 1629451109 · CALDWELL, ID 83605 · 1223G0001X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,021 | $43K |
| 2019 | 1,760 | $34K |
| 2020 | 635 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | 646 | 646 | $41K | |
| D0140 | 632 | 626 | $12K | |
| D1120 | 140 | 140 | $11K | |
| D2392 | 148 | 103 | $9K | |
| D0210 | 71 | 71 | $8K | |
| D7210 | 52 | 25 | $5K | |
| D0330 | 88 | 88 | $2K | |
| D0150 | 326 | 326 | $429.57 | |
| D0274 | 296 | 296 | $140.90 | |
| D0120 | 672 | 672 | $96.36 | |
| D1208 | 632 | 632 | $0.00 | |
| D0230 | 169 | 157 | $0.00 | |
| D0272 | 14 | 14 | $0.00 | |
| D0220 | 530 | 518 | $0.00 |