SALUD INTEGRAL EN LA MONTANA, INC
NPI: 1053892877
· COROZAL, PR 00783
· 261Q00000X
$527K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,124 |
$7K |
| 2021 |
18,385 |
$275K |
| 2022 |
7,597 |
$80K |
| 2023 |
4,660 |
$90K |
| 2024 |
7,197 |
$74K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
|
7,326 |
6,476 |
$85K |
| 0012A |
|
1,845 |
1,734 |
$73K |
| 90472 |
|
3,451 |
3,053 |
$60K |
| 0011A |
|
1,770 |
1,742 |
$54K |
| 0002A |
|
1,179 |
1,134 |
$42K |
| 0001A |
|
979 |
970 |
$32K |
| 0064A |
|
833 |
785 |
$31K |
| 0004A |
|
785 |
730 |
$25K |
| 90651 |
|
1,189 |
1,070 |
$17K |
| 0071A |
|
396 |
358 |
$14K |
| 0072A |
|
341 |
339 |
$13K |
| 90670 |
|
813 |
767 |
$12K |
| 90686 |
|
1,832 |
1,760 |
$11K |
| 90715 |
|
800 |
656 |
$11K |
| 90656 |
|
535 |
300 |
$9K |
| 90734 |
|
884 |
786 |
$5K |
| 0124A |
|
112 |
111 |
$4K |
| 90674 |
|
169 |
167 |
$4K |
| 0054A |
|
347 |
271 |
$3K |
| 91320 |
|
31 |
31 |
$3K |
| 90707 |
|
551 |
503 |
$3K |
| 90756 |
|
138 |
133 |
$2K |
| 0134A |
|
48 |
48 |
$2K |
| 90696 |
|
114 |
105 |
$1K |
| 90633 |
|
677 |
622 |
$1K |
| 91307 |
|
782 |
681 |
$1K |
| 90480 |
|
35 |
35 |
$1K |
| 90647 |
|
639 |
605 |
$912.59 |
| 90677 |
|
441 |
347 |
$899.26 |
| 90620 |
|
282 |
225 |
$628.75 |
| 0074A |
|
15 |
15 |
$600.00 |
| 90671 |
|
23 |
23 |
$519.96 |
| 0082A |
|
13 |
13 |
$480.00 |
| 90680 |
|
336 |
283 |
$308.80 |
| 90716 |
|
566 |
523 |
$208.03 |
| 90723 |
|
150 |
146 |
$157.44 |
| 90700 |
|
145 |
126 |
$8.00 |
| 90688 |
|
220 |
169 |
$4.01 |
| 91306 |
|
834 |
785 |
$0.18 |
| 91313 |
|
48 |
48 |
$0.00 |
| 91300 |
|
3,057 |
2,593 |
$0.00 |
| 91312 |
|
112 |
111 |
$0.00 |
| 91308 |
|
24 |
21 |
$0.00 |
| 91305 |
|
277 |
276 |
$0.00 |
| 91301 |
|
3,674 |
3,504 |
$0.00 |
| 90657 |
|
68 |
67 |
$0.00 |
| G0008 |
Admin influenza virus vac |
22 |
12 |
$0.00 |
| 90698 |
|
25 |
25 |
$0.00 |
| 90697 |
|
30 |
17 |
$0.00 |