STATE OF TENNESSEE
NPI: 1871643031
· TIPTONVILLE, TN 38079
· Public Health or Welfare Agency
· NPI assigned 01/11/2007
Provider Details
| Authorized Official | HARDEN, ANTHONY (REGIONAL DIRECTOR) |
| NPI Enumeration Date | 01/11/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
49 |
$560.40 |
| 2019 |
54 |
$715.00 |
| 2020 |
14 |
$224.67 |
| 2021 |
263 |
$5K |
| 2022 |
118 |
$2K |
| 2023 |
158 |
$2K |
| 2024 |
424 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
155 |
149 |
$5K |
| D1206 |
Topical application of fluoride varnish |
217 |
216 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
203 |
173 |
$3K |
| D0190 |
|
217 |
216 |
$2K |
| 99401 |
|
76 |
62 |
$2K |
| 0001A |
|
34 |
25 |
$1K |
| 0002A |
|
20 |
15 |
$617.76 |
| 0011A |
|
12 |
12 |
$360.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$80.40 |
| 90686 |
|
69 |
68 |
$75.00 |
| 90656 |
|
17 |
17 |
$0.00 |
| 90461 |
|
47 |
45 |
$0.00 |