SOUTH MOUNTAIN DIALYSIS, LLC
NPI: 1033159488
· SOUTH JORDAN, UT 84095
· 261QE0700X
$349K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
34 |
$0.00 |
| 2019 |
6,580 |
$92K |
| 2020 |
7,020 |
$59K |
| 2021 |
8,040 |
$129K |
| 2022 |
4,438 |
$68K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4657 |
Syringe w/wo needle |
7,361 |
545 |
$319K |
| 90999 |
|
6,309 |
511 |
$15K |
| 85018 |
|
1,569 |
612 |
$11K |
| J0887 |
Epoetin beta esrd use |
338 |
210 |
$2K |
| 84100 |
|
1,324 |
588 |
$1K |
| 87340 |
|
608 |
552 |
$451.51 |
| 83550 |
|
616 |
560 |
$376.10 |
| 84520 |
|
1,492 |
577 |
$273.06 |
| 82310 |
|
690 |
561 |
$98.92 |
| 82040 |
|
622 |
562 |
$83.07 |
| 82565 |
|
615 |
560 |
$0.00 |
| 83970 |
|
615 |
559 |
$0.00 |
| 84155 |
|
618 |
559 |
$0.00 |
| 83540 |
|
613 |
558 |
$0.00 |
| 82108 |
|
43 |
38 |
$0.00 |
| J1756 |
Iron sucrose injection |
543 |
139 |
$0.00 |
| 82374 |
|
17 |
14 |
$0.00 |
| 85025 |
|
608 |
545 |
$0.00 |
| 80051 |
|
611 |
556 |
$0.00 |
| 82728 |
|
615 |
560 |
$0.00 |
| G0008 |
Admin influenza virus vac |
54 |
52 |
$0.00 |
| 86706 |
|
46 |
41 |
$0.00 |
| J1270 |
Injection, doxercalciferol |
124 |
25 |
$0.00 |
| 90688 |
|
15 |
13 |
$0.00 |
| 86704 |
|
46 |
41 |
$0.00 |