GOOD SAMARITAN HOSPITAL CA LTD PTP
NPI: 1073103057
· WASCO, CA 93280
· 261QR1300X
$10.08M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
301 |
$7K |
| 2022 |
5,331 |
$401K |
| 2023 |
19,634 |
$2.01M |
| 2024 |
66,131 |
$7.66M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
32,163 |
11,284 |
$7.60M |
| 99309 |
|
39,163 |
6,581 |
$1.77M |
| 99213 |
|
9,504 |
4,939 |
$214K |
| 99308 |
|
4,337 |
605 |
$173K |
| 99214 |
|
1,117 |
667 |
$63K |
| 99305 |
|
926 |
543 |
$61K |
| G0467 |
Fqhc visit, estab pt |
320 |
275 |
$54K |
| 90792 |
|
212 |
212 |
$42K |
| 99204 |
|
209 |
143 |
$15K |
| 99310 |
Prolong nursin fac eval 15m |
324 |
215 |
$13K |
| 99306 |
Prolong nursin fac eval 15m |
98 |
60 |
$11K |
| 99307 |
|
364 |
105 |
$10K |
| 99304 |
|
352 |
225 |
$9K |
| 59425 |
|
64 |
43 |
$9K |
| 96372 |
|
458 |
333 |
$7K |
| 99350 |
Prolong home eval add 15m |
52 |
48 |
$6K |
| 99345 |
Prolong home eval add 15m |
78 |
64 |
$6K |
| 99212 |
|
149 |
102 |
$5K |
| 99395 |
|
48 |
27 |
$3K |
| 90740 |
|
19 |
18 |
$3K |
| 90658 |
|
68 |
68 |
$2K |
| 82947 |
|
370 |
242 |
$879.27 |
| J3420 |
Vitamin b12 injection |
141 |
128 |
$816.05 |
| 81003 |
|
202 |
176 |
$276.75 |
| 99203 |
|
35 |
32 |
$171.60 |
| 99348 |
|
37 |
30 |
$68.22 |
| 82948 |
|
18 |
16 |
$39.11 |
| 99421 |
|
399 |
359 |
$0.00 |
| 99422 |
|
170 |
149 |
$0.00 |