REVITALIZED WELLNESS PLLC
NPI: 1760093025
· SIOUX FALLS, SD 57103
· 101YP2500X
$646K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
43 |
$107.65 |
| 2022 |
3,646 |
$163K |
| 2023 |
6,726 |
$244K |
| 2024 |
5,063 |
$239K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
5,014 |
2,531 |
$390K |
| 99215 |
Prolong outpt/office vis |
887 |
361 |
$81K |
| 99401 |
|
1,863 |
1,017 |
$43K |
| 99402 |
|
1,251 |
537 |
$39K |
| 99404 |
|
690 |
291 |
$36K |
| 99406 |
|
3,597 |
1,648 |
$20K |
| 82075 |
|
1,201 |
660 |
$19K |
| 99204 |
|
69 |
66 |
$8K |
| 96372 |
|
535 |
312 |
$6K |
| 99205 |
Prolong outpt/office vis |
17 |
14 |
$2K |
| 80305 |
|
87 |
52 |
$368.66 |
| J3420 |
Vitamin b12 injection |
84 |
44 |
$99.39 |
| 99213 |
|
77 |
50 |
$72.64 |
| 96127 |
|
25 |
25 |
$64.58 |
| 81025 |
|
14 |
12 |
$63.90 |
| J2001 |
Lidocaine injection |
52 |
29 |
$1.56 |
| 99408 |
|
15 |
14 |
$0.00 |