SALUD INTEGRAL EN LA MONTANA, INC
NPI: 1124509948
· BARRANQUITAS, PR 00794
· 261Q00000X
$468K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
873 |
$3K |
| 2020 |
4,296 |
$26K |
| 2021 |
13,873 |
$198K |
| 2022 |
6,663 |
$80K |
| 2023 |
5,316 |
$124K |
| 2024 |
4,368 |
$37K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
|
8,376 |
7,065 |
$77K |
| 0004A |
|
1,584 |
908 |
$40K |
| 90472 |
|
3,320 |
2,746 |
$37K |
| 90651 |
|
774 |
626 |
$33K |
| 0012A |
|
737 |
735 |
$29K |
| 0002A |
|
724 |
713 |
$25K |
| 0001A |
|
819 |
784 |
$25K |
| 0011A |
|
798 |
785 |
$24K |
| 91307 |
|
1,206 |
1,113 |
$20K |
| 0072A |
|
537 |
534 |
$20K |
| 90670 |
|
878 |
769 |
$20K |
| 90686 |
|
2,403 |
2,246 |
$16K |
| 90677 |
|
330 |
274 |
$15K |
| 0071A |
|
615 |
613 |
$15K |
| 0054A |
|
575 |
543 |
$15K |
| 0064A |
|
644 |
375 |
$14K |
| 90621 |
|
118 |
87 |
$8K |
| 90656 |
|
921 |
690 |
$7K |
| 0124A |
|
178 |
137 |
$7K |
| 90715 |
|
318 |
248 |
$4K |
| 90716 |
|
355 |
309 |
$4K |
| 90707 |
|
366 |
315 |
$3K |
| 90680 |
|
295 |
247 |
$2K |
| 90633 |
|
425 |
347 |
$2K |
| 90620 |
|
18 |
12 |
$2K |
| 90697 |
|
132 |
101 |
$1K |
| 90696 |
|
54 |
46 |
$832.00 |
| 0003A |
|
15 |
15 |
$600.00 |
| 0074A |
|
13 |
13 |
$520.00 |
| 90732 |
|
25 |
25 |
$269.85 |
| 90688 |
|
508 |
504 |
$131.88 |
| 90674 |
|
72 |
72 |
$87.66 |
| 90734 |
|
240 |
221 |
$44.00 |
| 90681 |
|
33 |
30 |
$4.00 |
| 90700 |
|
40 |
37 |
$4.00 |
| 90647 |
|
25 |
25 |
$4.00 |
| 90744 |
|
12 |
12 |
$4.00 |
| 90698 |
|
113 |
102 |
$4.00 |
| 91306 |
|
636 |
373 |
$1.15 |
| 90619 |
|
440 |
329 |
$0.03 |
| 91300 |
|
3,490 |
2,453 |
$0.02 |
| 90685 |
|
153 |
96 |
$0.00 |
| 91312 |
|
178 |
137 |
$0.00 |
| 91305 |
|
190 |
183 |
$0.00 |
| 90657 |
|
102 |
89 |
$0.00 |
| 91301 |
|
1,533 |
1,505 |
$0.00 |
| G0008 |
Admin influenza virus vac |
71 |
60 |
$0.00 |