NPI: 1861954026 · STAR, ID 83669 · 1223X0400X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 496 | $7K |
| 2021 | 1,848 | $31K |
| 2022 | 1,571 | $28K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | 719 | 718 | $33K | |
| D1110 | 137 | 136 | $11K | |
| D2392 | 52 | 30 | $6K | |
| D0330 | 72 | 72 | $5K | |
| D0150 | 207 | 207 | $5K | |
| D2391 | 64 | 29 | $3K | |
| D0120 | 519 | 517 | $1K | |
| D1351 | 346 | 71 | $676.65 | |
| D0140 | 17 | 17 | $616.49 | |
| D9230 | 270 | 237 | $291.49 | |
| D0272 | 505 | 505 | $246.00 | |
| D1208 | 621 | 621 | $0.00 | |
| D0274 | 77 | 76 | $0.00 | |
| D0220 | 12 | 12 | $0.00 | |
| D1206 | 297 | 296 | $-98.29 |