BUCK JACK, LLC DBA THE SHANDY CLINIC
NPI: 1891443370
· PUEBLO, CO 81005
· Physical Therapist
· NPI assigned 03/14/2022
$679K
Total Medicaid Paid
Provider Details
| Authorized Official | DENN, TANNER (CREDENTIALING SPECIALIST) |
| NPI Enumeration Date | 03/14/2022 |
Related Entities
Other providers sharing the same authorized official: DENN, TANNER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
755 |
$162K |
| 2023 |
1,532 |
$364K |
| 2024 |
561 |
$153K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97153 |
Adaptive behavior treatment by protocol, administered by technician, each 15 minutes |
2,184 |
213 |
$572K |
| 97155 |
Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes |
664 |
183 |
$108K |