NPI: 1124403258 · REXBURG, ID 83440 · 261QU0200X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 5,820 | $511K |
| 2019 | 7,007 | $608K |
| 2020 | 13,535 | $1.05M |
| 2021 | 15,454 | $1.26M |
| 2022 | 17,338 | $1.36M |
| 2023 | 19,788 | $1.50M |
| 2024 | 19,808 | $1.36M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0999 | 16,279 | 14,769 | $4.20M | |
| T1015 | Clinic service | 18,481 | 15,669 | $3.42M |
| 99213 | 11,270 | 9,417 | $16K | |
| 90471 | 823 | 820 | $3K | |
| 36415 | 1,307 | 1,214 | $1K | |
| 90686 | 269 | 268 | $1K | |
| 99238 | 15 | 14 | $887.88 | |
| 90472 | 485 | 483 | $844.45 | |
| G0008 | Admin influenza virus vac | 158 | 157 | $812.70 |
| 80053 | 943 | 929 | $748.91 | |
| 0011A | 34 | 34 | $684.42 | |
| 81002 | 337 | 204 | $577.73 | |
| 0012A | 27 | 27 | $523.38 | |
| 85025 | 610 | 599 | $389.50 | |
| 90460 | 839 | 838 | $38.58 | |
| 80061 | 44 | 43 | $33.27 | |
| 83036 | 94 | 93 | $27.74 | |
| 99391 | 1,124 | 1,036 | $1.47 | |
| 99214 | 1,995 | 1,868 | $0.00 | |
| D0120 | 3,398 | 3,393 | $0.00 | |
| D0230 | 11,116 | 4,645 | $0.00 | |
| D0140 | 648 | 624 | $0.00 | |
| D0150 | 2,565 | 2,563 | $0.00 | |
| 3074F | 894 | 805 | $0.00 | |
| D7140 | 203 | 80 | $0.00 | |
| 3079F | 282 | 271 | $0.00 | |
| 3075F | 97 | 96 | $0.00 | |
| D1206 | 319 | 319 | $0.00 | |
| D2393 | 44 | 39 | $0.00 | |
| D0330 | 2,438 | 2,432 | $0.00 | |
| D0274 | 3,965 | 3,958 | $0.00 | |
| 3078F | 575 | 523 | $0.00 | |
| D1110 | 3,711 | 3,707 | $0.00 | |
| 1160F | 1,563 | 1,422 | $0.00 | |
| 1159F | 1,563 | 1,422 | $0.00 | |
| 90461 | 552 | 552 | $0.00 | |
| 99392 | 336 | 336 | $0.00 | |
| D2391 | 214 | 159 | $0.00 | |
| 90670 | 13 | 13 | $0.00 | |
| 90671 | 25 | 25 | $0.00 | |
| D1120 | 25 | 25 | $0.00 | |
| D4910 | 12 | 12 | $0.00 | |
| 99203 | 16 | 16 | $0.00 | |
| D0220 | 6,346 | 6,237 | $-36.37 | |
| D2392 | 2,696 | 1,763 | $-216.64 |