Medicaid Provider Spending

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

REVITALIZE HYDRATION THERAPY, LLC

NPI: 1285261123 · FLOWOOD, MS 39232 · Gerontology Nurse Practitioner · NPI assigned 03/23/2020

$192.08
Total Medicaid Paid
17
Total Claims
12
Beneficiaries
1
Codes Billed
2024-10
First Month
2024-10
Last Month

Provider Details

Authorized OfficialMARDIS, JENNYE (STAFF)
NPI Enumeration Date03/23/2020

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 17 $192.08

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 17 12 $192.08