NPI: 1063576445 · POCATELLO, ID 83201 · 251K00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 5,068 | $52K |
| 2019 | 4,362 | $47K |
| 2020 | 3,128 | $41K |
| 2021 | 3,218 | $34K |
| 2022 | 3,254 | $86K |
| 2023 | 1,551 | $68K |
| 2024 | 1,863 | $57K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1017 | Targeted case management | 480 | 271 | $119K |
| 90471 | 4,921 | 4,741 | $85K | |
| 90472 | 2,215 | 2,120 | $41K | |
| D0191 | 3,408 | 3,406 | $37K | |
| D1351 | 1,890 | 426 | $28K | |
| 99211 | 1,175 | 1,134 | $21K | |
| J1050 | Medroxyprogesterone acetate | 584 | 567 | $15K |
| 91320 | 105 | 105 | $9K | |
| 90686 | 1,334 | 1,333 | $6K | |
| 90480 | 147 | 147 | $5K | |
| 90651 | 489 | 474 | $4K | |
| 87591 | 116 | 99 | $3K | |
| 96372 | 160 | 156 | $3K | |
| 81025 | 289 | 263 | $2K | |
| 90715 | 525 | 510 | $2K | |
| 90734 | 507 | 499 | $1K | |
| 99212 | 30 | 30 | $1K | |
| 90620 | 78 | 78 | $1K | |
| D1120 | 14 | 14 | $768.79 | |
| 90656 | 96 | 95 | $607.27 | |
| S4993 | Contraceptive pills for bc | 25 | 24 | $330.50 |
| D1206 | 3,269 | 3,267 | $76.03 | |
| 36415 | 14 | 14 | $32.40 | |
| 90633 | 106 | 96 | $7.84 | |
| 90710 | 92 | 91 | $0.00 | |
| 90685 | 13 | 13 | $0.00 | |
| 90670 | 149 | 133 | $0.00 | |
| 90723 | 24 | 24 | $0.00 | |
| 90619 | 99 | 99 | $0.00 | |
| 90696 | 75 | 73 | $0.00 | |
| 90647 | 15 | 14 | $0.00 |