LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
NPI: 1871272583
· PETOSKEY, MI 49770
· 261QF0400X
$353K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
3,119 |
$170K |
| 2024 |
3,807 |
$183K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0467 |
Fqhc visit, estab pt |
2,341 |
1,830 |
$155K |
| G0470 |
Fqhc visit, mh estab pt |
388 |
189 |
$51K |
| G0466 |
Fqhc visit new patient |
558 |
556 |
$50K |
| 99214 |
|
804 |
726 |
$33K |
| 99213 |
|
932 |
822 |
$27K |
| 99215 |
Prolong outpt/office vis |
174 |
156 |
$10K |
| G0468 |
Fqhc visit, ippe or awv |
139 |
138 |
$10K |
| 99204 |
|
84 |
83 |
$3K |
| 87635 |
|
197 |
177 |
$3K |
| 99203 |
|
57 |
57 |
$2K |
| 87804 |
|
297 |
141 |
$2K |
| 87880 |
|
228 |
202 |
$1K |
| 99202 |
|
62 |
62 |
$1K |
| 90471 |
|
111 |
107 |
$951.67 |
| 36415 |
|
254 |
242 |
$940.45 |
| 99212 |
|
42 |
40 |
$697.13 |
| 99395 |
|
13 |
13 |
$544.98 |
| U0002 |
Covid-19 lab test non-cdc |
52 |
50 |
$467.48 |
| 80305 |
|
34 |
27 |
$198.17 |
| 96127 |
|
47 |
44 |
$130.14 |
| 93005 |
|
54 |
52 |
$102.39 |
| 81025 |
|
18 |
15 |
$57.04 |
| 87807 |
|
14 |
12 |
$32.55 |
| 81002 |
|
14 |
13 |
$17.28 |
| 81003 |
|
12 |
12 |
$11.22 |