NPI: 1649212689 · PRESTON, ID 83263 · 1223G0001X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,185 | $43K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | 242 | 241 | $16K | |
| D1120 | 230 | 229 | $11K | |
| D2150 | 272 | 146 | $9K | |
| D7140 | 44 | 27 | $2K | |
| D2160 | 33 | 24 | $2K | |
| D0150 | 44 | 44 | $883.62 | |
| D0330 | 13 | 13 | $874.41 | |
| D0140 | 14 | 14 | $289.64 | |
| D0120 | 366 | 365 | $142.70 | |
| D2140 | 15 | 12 | $78.84 | |
| D0274 | 155 | 154 | $63.61 | |
| D0220 | 133 | 131 | $34.82 | |
| D0230 | 72 | 24 | $0.00 | |
| D1208 | 401 | 399 | $0.00 | |
| D0272 | 13 | 12 | $0.00 | |
| D9230 | 138 | 129 | $0.00 |