NPI: 1073846655 · WEST JORDAN, UT 84088 · 261QE0700X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,458 | $113K |
| 2019 | 2,826 | $103K |
| 2020 | 1,494 | $25K |
| 2021 | 1,713 | $24K |
| 2022 | 4,904 | $168K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4657 | Syringe w/wo needle | 3,458 | 369 | $301K |
| 90999 | 4,289 | 339 | $67K | |
| 82310 | 365 | 314 | $16K | |
| 82565 | 366 | 323 | $9K | |
| 82728 | 100 | 91 | $8K | |
| 83550 | 395 | 352 | $8K | |
| 86706 | 87 | 75 | $8K | |
| 83540 | 394 | 352 | $8K | |
| 83970 | 98 | 90 | $8K | |
| 84100 | 381 | 316 | $766.77 | |
| 84520 | 709 | 354 | $697.11 | |
| 85025 | 303 | 264 | $13.47 | |
| 82040 | 351 | 312 | $0.00 | |
| 87340 | 381 | 340 | $0.00 | |
| G0008 | Admin influenza virus vac | 28 | 26 | $0.00 |
| 82607 | 14 | 12 | $0.00 | |
| 80051 | 13 | 12 | $0.00 | |
| 82746 | 15 | 13 | $0.00 | |
| 84132 | 70 | 49 | $0.00 | |
| 80069 | 27 | 24 | $0.00 | |
| 84155 | 379 | 339 | $0.00 | |
| 84295 | 26 | 24 | $0.00 | |
| 82374 | 64 | 50 | $0.00 | |
| 82947 | 26 | 24 | $0.00 | |
| J1756 | Iron sucrose injection | 56 | 13 | $0.00 |