NPI: 1235260795 · SALT LAKE CITY, UT 84190 · 251K00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 23,748 | $1.34M |
| 2019 | 21,806 | $1.23M |
| 2020 | 15,882 | $786K |
| 2021 | 13,922 | $1.01M |
| 2022 | 15,514 | $877K |
| 2023 | 18,918 | $1.07M |
| 2024 | 16,417 | $1.22M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1023 | Program intake assessment | 23,281 | 22,603 | $5.86M |
| 90471 | 25,162 | 23,999 | $1.08M | |
| T1017 | Targeted case management | 1,146 | 1,075 | $71K |
| 90716 | 3,071 | 3,018 | $70K | |
| 90739 | 1,587 | 1,500 | $69K | |
| 91322 | 851 | 849 | $55K | |
| 90472 | 15,385 | 14,778 | $50K | |
| 90651 | 4,803 | 4,731 | $45K | |
| 90473 | 810 | 770 | $36K | |
| 90707 | 2,381 | 2,265 | $33K | |
| 90632 | 1,665 | 1,472 | $27K | |
| 90677 | 293 | 293 | $25K | |
| 90715 | 5,882 | 5,603 | $23K | |
| 90750 | 371 | 326 | $17K | |
| 90480 | 1,438 | 1,429 | $10K | |
| 90713 | 2,495 | 2,457 | $8K | |
| 90620 | 705 | 691 | $8K | |
| 90688 | 1,833 | 1,754 | $7K | |
| 90619 | 1,298 | 1,283 | $6K | |
| 90673 | 99 | 99 | $5K | |
| 86580 | 803 | 713 | $4K | |
| 0124A | 405 | 371 | $3K | |
| 91320 | 51 | 50 | $2K | |
| 91304 | 19 | 19 | $2K | |
| 90658 | 83 | 83 | $1K | |
| 0051A | 78 | 74 | $1K | |
| 90734 | 2,457 | 2,419 | $1K | |
| 0011A | 166 | 125 | $1K | |
| 90686 | 6,908 | 6,775 | $994.00 | |
| 0012A | 84 | 83 | $810.00 | |
| 0134A | 78 | 75 | $789.62 | |
| 0154A | 115 | 107 | $510.00 | |
| G0008 | Admin influenza virus vac | 19 | 18 | $501.57 |
| 0052A | 109 | 99 | $434.00 | |
| 0001A | 58 | 57 | $420.00 | |
| 90746 | 337 | 275 | $419.67 | |
| 90670 | 2,220 | 2,142 | $346.31 | |
| 90682 | 807 | 772 | $303.62 | |
| 90732 | 314 | 276 | $278.27 | |
| 0002A | 21 | 21 | $225.00 | |
| 0071A | 26 | 25 | $205.00 | |
| 90696 | 1,322 | 1,305 | $188.50 | |
| 90633 | 4,094 | 4,035 | $174.00 | |
| 90672 | 206 | 202 | $123.50 | |
| 90636 | 524 | 442 | $91.81 | |
| 90714 | 222 | 216 | $87.00 | |
| 90680 | 557 | 525 | $87.00 | |
| 0072A | 31 | 31 | $75.00 | |
| 90700 | 1,141 | 1,127 | $72.50 | |
| 90723 | 1,093 | 1,059 | $43.50 | |
| 90744 | 1,029 | 1,015 | $36.00 | |
| 0173A | 12 | 12 | $30.00 | |
| 90710 | 2,154 | 2,121 | $29.00 | |
| 90647 | 1,025 | 986 | $29.00 | |
| 91312 | 415 | 378 | $0.01 | |
| 91308 | 45 | 43 | $0.00 | |
| 91321 | 282 | 281 | $0.00 | |
| 90671 | 98 | 97 | $0.00 | |
| 91313 | 102 | 99 | $0.00 | |
| 91300 | 96 | 78 | $0.00 | |
| 90685 | 196 | 189 | $0.00 | |
| 91317 | 24 | 24 | $0.00 | |
| 90698 | 687 | 670 | $0.00 | |
| 90697 | 108 | 104 | $0.00 | |
| 91305 | 183 | 163 | $0.00 | |
| 91315 | 121 | 113 | $0.00 | |
| 91301 | 268 | 227 | $0.00 | |
| 91307 | 91 | 84 | $0.00 | |
| 90656 | 304 | 303 | $0.00 | |
| 91319 | 49 | 49 | $0.00 | |
| 91318 | 14 | 14 | $0.00 |