IDAHO FALLS ASC
NPI: 1174005235
· IDAHO FALLS, ID 83404
· Ambulatory Surgical Clinic/Center
· NPI assigned 09/05/2018
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official HILLYARD, NED controls 11+ related entities in our dataset. Read more
$386K
Total Medicaid Paid
Provider Details
| Authorized Official | HILLYARD, NED (CCO) |
| NPI Enumeration Date | 09/05/2018 |
Related Entities
Other providers sharing the same authorized official: HILLYARD, NED
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2021 |
24 |
$8K |
| 2022 |
480 |
$133K |
| 2023 |
447 |
$106K |
| 2024 |
582 |
$139K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
318 |
318 |
$193K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
296 |
295 |
$138K |
| D9420 |
|
861 |
858 |
$48K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
28 |
28 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
16 |
16 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
14 |
14 |
$2K |