NPI: 1679687669 · NEILLSVILLE, WI 54456 · 333600000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 18 | $425.97 |
| 2020 | 48 | $1K |
| 2021 | 528 | $7K |
| 2022 | 97 | $3K |
| 2024 | 390 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0002A | 106 | 95 | $3K | |
| S9430 | Pharmacy comp/disp serv | 176 | 173 | $3K |
| 0001A | 125 | 104 | $3K | |
| 91322 | 13 | 13 | $2K | |
| 90750 | 38 | 25 | $2K | |
| A9150 | Misc/exper non-prescript dru | 150 | 150 | $2K |
| 90688 | 68 | 54 | $1K | |
| 90682 | 21 | 12 | $757.32 | |
| 90656 | 19 | 19 | $617.64 | |
| 90480 | 13 | 13 | $496.08 | |
| 90686 | 14 | 14 | $464.10 | |
| 0124A | 12 | 12 | $457.92 | |
| 0004A | 13 | 13 | $419.76 | |
| 91300 | 282 | 224 | $0.00 | |
| 91312 | 12 | 12 | $0.00 | |
| G0008 | Admin influenza virus vac | 19 | 19 | $0.00 |