MADISON CO MEMORIAL HOSPITAL
NPI: 1134592017
· REXBURG, ID 83440
· Family Medicine Physician
· NPI assigned 11/02/2015
$1.56M
Total Medicaid Paid
Provider Details
| Authorized Official | GONZALES, RACHEL (CHIEF EXECUTIVE OFFICER) |
| Parent Organization | MADISON CO MEMORIAL HOSPITAL |
| NPI Enumeration Date | 11/02/2015 |
Related Entities
Other providers sharing the same authorized official: GONZALES, RACHEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
5,888 |
$242K |
| 2019 |
5,300 |
$220K |
| 2020 |
5,545 |
$223K |
| 2021 |
4,482 |
$223K |
| 2022 |
5,084 |
$263K |
| 2023 |
3,936 |
$231K |
| 2024 |
2,539 |
$160K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
17,184 |
15,987 |
$1.01M |
| 99391 |
|
2,275 |
1,936 |
$200K |
| 90461 |
|
2,061 |
1,532 |
$89K |
| 99392 |
|
872 |
864 |
$88K |
| 90460 |
|
2,330 |
2,310 |
$64K |
| 99214 |
|
679 |
631 |
$61K |
| 87502 |
|
177 |
173 |
$15K |
| 99393 |
|
81 |
81 |
$8K |
| 36415 |
|
2,345 |
2,163 |
$7K |
| 96372 |
|
437 |
307 |
$5K |
| 99394 |
|
31 |
31 |
$3K |
| 99212 |
|
80 |
75 |
$3K |
| 90471 |
|
159 |
157 |
$3K |
| 90686 |
|
940 |
930 |
$2K |
| 99395 |
|
12 |
12 |
$1K |
| 99203 |
|
14 |
14 |
$1K |
| 99460 |
|
12 |
12 |
$956.56 |
| 87651 |
|
30 |
28 |
$956.23 |
| 85025 |
|
148 |
131 |
$841.51 |
| 99238 |
|
12 |
12 |
$761.04 |
| 85027 |
|
91 |
89 |
$520.50 |
| 87635 |
|
12 |
12 |
$507.98 |
| 90474 |
|
44 |
44 |
$463.76 |
| 90682 |
|
15 |
15 |
$388.91 |
| 90677 |
|
39 |
39 |
$255.36 |
| 90472 |
|
13 |
13 |
$192.80 |
| 87430 |
|
12 |
12 |
$151.30 |
| 80053 |
|
13 |
12 |
$95.71 |
| 90680 |
|
515 |
515 |
$22.06 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16 |
14 |
$19.79 |
| 90670 |
|
1,041 |
1,039 |
$15.64 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14 |
13 |
$8.47 |
| 90723 |
|
471 |
470 |
$4.61 |
| 90647 |
|
442 |
442 |
$4.36 |
| 90633 |
|
45 |
44 |
$0.43 |
| 90697 |
|
112 |
112 |
$0.28 |