SIOUX VALLEY MEMORIAL HOSPITAL ASSOCIATION
NPI: 1164122685
· CHEROKEE, IA 51012
· Public Health or Welfare Agency
· NPI assigned 03/03/2023
$252K
Total Medicaid Paid
Provider Details
| Authorized Official | BIERMAN, JOAN (SR VP OF FINANCE) |
| Parent Organization | SIOUX VALLEY MEMORIAL HOSPITAL ASSOCIATION |
| NPI Enumeration Date | 03/03/2023 |
Related Entities
Other providers sharing the same authorized official: BIERMAN, JOAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
8,307 |
$112K |
| 2024 |
9,946 |
$140K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0190 |
|
4,055 |
3,981 |
$73K |
| D1206 |
Topical application of fluoride varnish |
4,066 |
3,999 |
$67K |
| D1330 |
|
2,425 |
2,373 |
$41K |
| D1351 |
Sealant - per tooth |
1,702 |
463 |
$39K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
794 |
693 |
$11K |
| 83655 |
|
316 |
272 |
$5K |
| D1353 |
|
236 |
92 |
$5K |
| D0602 |
|
3,097 |
3,033 |
$3K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
113 |
98 |
$3K |
| D0603 |
|
904 |
896 |
$949.30 |
| D9990 |
|
65 |
64 |
$946.89 |
| G0451 |
Development testing, with interpretation and report, per standardized instrument form |
13 |
13 |
$799.63 |
| 99000 |
|
280 |
255 |
$736.06 |
| 96161 |
|
103 |
81 |
$556.92 |
| D1354 |
|
56 |
15 |
$240.80 |
| D0601 |
|
28 |
28 |
$27.50 |