NPI: 1669445490 · HAVRE, MT 59501 · 261Q00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 11,242 | $12K |
| 2019 | 10,744 | $2K |
| 2020 | 11,571 | $3K |
| 2021 | 12,472 | $6K |
| 2022 | 11,838 | $8K |
| 2023 | 12,359 | $4K |
| 2024 | 7,431 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 93010 | 2,634 | 2,098 | $17K | |
| 92340 | 505 | 463 | $11K | |
| 90791 | 1,746 | 1,642 | $4K | |
| 74177 | 14 | 13 | $2K | |
| 70450 | 28 | 26 | $1K | |
| 99214 | 10,602 | 9,078 | $708.12 | |
| 99239 | 14 | 12 | $677.46 | |
| 71046 | 44 | 43 | $547.24 | |
| 90834 | 9,041 | 5,423 | $274.00 | |
| 99213 | 12,729 | 10,759 | $139.54 | |
| 71045 | 12 | 12 | $132.00 | |
| 73630 | 210 | 181 | $131.95 | |
| 92004 | 2,115 | 1,924 | $120.86 | |
| 92014 | 3,294 | 3,077 | $115.00 | |
| 99203 | 3,654 | 3,399 | $92.73 | |
| 99202 | 1,532 | 1,466 | $42.59 | |
| 73110 | 319 | 241 | $21.44 | |
| J3301 | Triamcinolone acet inj nos | 1,023 | 953 | $0.00 |
| 90837 | 3,391 | 1,812 | $0.00 | |
| 99215 | Prolong outpt/office vis | 698 | 581 | $0.00 |
| 99204 | 945 | 874 | $0.00 | |
| 92015 | 4,825 | 4,453 | $0.00 | |
| 90785 | 3,927 | 2,737 | $0.00 | |
| 99212 | 5,347 | 4,389 | $0.00 | |
| 99490 | Ccm add 20min | 584 | 318 | $0.00 |
| A6402 | Sterile gauze <= 16 sq in | 98 | 82 | $0.00 |
| 92012 | 313 | 266 | $0.00 | |
| 96101 | 19 | 13 | $0.00 | |
| G0511 | Ccm/bhi by rhc/fqhc 20min mo | 261 | 255 | $0.00 |
| 99307 | 474 | 289 | $0.00 | |
| 73130 | 63 | 48 | $0.00 | |
| A6212 | Foam drg <=16 sq in w/border | 56 | 36 | $0.00 |
| 96130 | 135 | 119 | $0.00 | |
| 90832 | 35 | 26 | $0.00 | |
| 99442 | 13 | 12 | $0.00 | |
| 73030 | 43 | 39 | $0.00 | |
| 11042 | 82 | 37 | $0.00 | |
| 73562 | 15 | 12 | $0.00 | |
| J3300 | Triamcinolone a inj prs-free | 14 | 12 | $0.00 |
| 73610 | 40 | 36 | $0.00 | |
| 99308 | 765 | 661 | $0.00 | |
| 36415 | 4,498 | 4,102 | $0.00 | |
| 20610 | 608 | 564 | $0.00 | |
| 99309 | 238 | 115 | $0.00 | |
| 90686 | 118 | 106 | $0.00 | |
| 90792 | 129 | 125 | $0.00 | |
| G0008 | Admin influenza virus vac | 102 | 91 | $0.00 |
| 99441 | 71 | 64 | $0.00 | |
| 96127 | 16 | 16 | $0.00 | |
| A6454 | Self-adher band w>=3" <5"/yd | 20 | 14 | $0.00 |
| G2025 | Dis site tele svcs rhc/fqhc | 56 | 53 | $0.00 |
| 73564 | 129 | 68 | $0.00 | |
| 96372 | 13 | 13 | $0.00 |