SB OPERATING COMPANY LLC

NPI: 1326467960 · WILLIAMSTOWN, MA 01267 · Skilled Nursing Facility · NPI assigned 04/10/2014

$11K

Total Medicaid Paid

1,150

Total Claims

248

Beneficiaries

Codes Billed

2018-01

First Month

2019-11

Last Month

Provider Details

Authorized Official	SHERMAN, ALEXANDER (MEMBER)
NPI Enumeration Date	04/10/2014

Other providers sharing the same authorized official: SHERMAN, ALEXANDER

Provider	City	State	Total Paid
RIVERDALE SPORTS PHYSICAL THERAPY PC	BRONX	NY	$7K
EDGEWOOD MANOR OF LUCASVILLE II LLC	LUCASVILLE	OH	$2K
EDGEWOOD MANOR OF LUCASVILLE I LLC	LUCASVILLE	OH	$2K
EDGEWOOD MANOR OF GREENFIELD LLC	GREENFIELD	OH	$0.00

Year	Claims	Total Paid
2018	1,007	$9K
2019	143	$2K

Code	Description	Claims	Beneficiaries	Total Paid
97530		726	99	$11K
90686		14	14	$0.00
G0008	Administration of influenza virus vaccine	49	49	$0.00
90656		35	35	$0.00
G8979	Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	42	12	$0.00
97110		244	27	$0.00
G8978	Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals	40	12	$0.00