WREN HOLLOW MEDICAL LLC
NPI: 1245826981
· SOUTH JORDAN, UT 84095
· Community Health Clinic/Center
· NPI assigned 12/16/2020
$264K
Total Medicaid Paid
Provider Details
| Authorized Official | GRAY, KRISTA (OWNER) |
| NPI Enumeration Date | 12/16/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
368 |
$2K |
| 2021 |
17,027 |
$184K |
| 2022 |
5,608 |
$78K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
10,142 |
8,284 |
$212K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12,723 |
10,130 |
$52K |
| 86328 |
|
138 |
130 |
$135.69 |