Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › ID › BOISE › THE PEDIATRIC AND ADOLESCENT CENTER, INC.

THE PEDIATRIC AND ADOLESCENT CENTER, INC.

NPI: 1144341637 · BOISE, ID 83713 · Legal Medicine · NPI assigned 04/02/2007

$31K
Total Medicaid Paid
609
Total Claims
566
Beneficiaries
4
Codes Billed
2018-01
First Month
2018-07
Last Month

Provider Details

Authorized OfficialBOURQUARD, WILLIAM (OWNER)
NPI Enumeration Date04/02/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 609 $31K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 456 414 $27K
90460 Immunization administration through 18 years of age via any route, first or only component 113 112 $2K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 27 27 $2K
90686 13 13 $0.13