Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

MUNICIPIO DE SABANA GRANDE

NPI: 1194945949 · SABANA GRANDE, PR 00637 · Clinic/Center · NPI assigned 04/26/2007

$38K
Total Medicaid Paid
14,644
Total Claims
13,693
Beneficiaries
22
Codes Billed
2018-01
First Month
2020-06
Last Month

Provider Details

Authorized OfficialMENDEZ, ULISES (COORDINADOR DE SERVICIOS DE SALUD)
NPI Enumeration Date04/26/2007

Related Entities

Other providers sharing the same authorized official: MENDEZ, ULISES

ProviderCityStateTotal Paid
MUNICIPIO DE SABANA GRANDE SABANA GRANDE PR $43K
MUNICIPIO DE SABANA GRANDE SABANA GRANDE PR $25K
MUNICIPIO DE SABANA GRANDE SABANA GRANDE PR $189.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 7,552 $18K
2019 5,514 $15K
2020 1,578 $4K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90472 Immunization administration, each additional vaccine (list separately) 2,780 2,493 $20K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 4,104 3,862 $16K
90651 966 921 $246.36
90474 60 60 $232.00
90716 687 646 $176.06
90734 600 562 $162.21
90715 378 365 $142.85
90707 636 601 $131.67
90633 625 581 $67.31
90686 477 466 $50.29
90670 1,029 978 $48.29
90688 108 108 $37.58
90648 638 598 $36.16
90620 212 183 $36.02
90621 190 178 $30.09
90698 262 256 $12.04
90723 278 253 $12.04
90700 186 168 $6.05
90696 170 156 $6.01
90744 42 42 $0.04
90680 88 88 $0.03
90681 128 128 $0.02