GOOD SAMARITAN MEDICAL CENTER, LLC
NPI: 1407845035
· LAFAYETTE, CO 80026
· 282N00000X
$1.24M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
8,422 |
$201K |
| 2019 |
8,172 |
$153K |
| 2020 |
5,255 |
$86K |
| 2021 |
9,951 |
$171K |
| 2022 |
12,267 |
$227K |
| 2023 |
14,256 |
$248K |
| 2024 |
8,291 |
$159K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
5,337 |
4,594 |
$560K |
| 99283 |
|
4,155 |
3,708 |
$399K |
| 80048 |
|
7,342 |
6,266 |
$98K |
| 99285 |
|
653 |
513 |
$77K |
| J3490 |
Drugs unclassified injection |
17,341 |
8,700 |
$40K |
| 80053 |
|
2,544 |
2,274 |
$27K |
| 85025 |
|
17,994 |
15,332 |
$18K |
| 84443 |
|
804 |
773 |
$9K |
| 83036 |
|
726 |
703 |
$5K |
| 80061 |
|
581 |
551 |
$3K |
| 84484 |
|
213 |
115 |
$2K |
| 0241U |
|
33 |
27 |
$2K |
| 96374 |
|
2,669 |
2,319 |
$2K |
| 80076 |
|
81 |
78 |
$1K |
| G0472 |
Hep c screen high risk/other |
37 |
34 |
$839.40 |
| 93005 |
|
1,369 |
1,120 |
$788.18 |
| 80307 |
|
12 |
12 |
$757.44 |
| 36415 |
|
306 |
251 |
$598.79 |
| G0432 |
Eia hiv-1/hiv-2 screen |
53 |
52 |
$308.11 |
| 96375 |
|
616 |
516 |
$108.68 |
| 81001 |
|
408 |
327 |
$22.82 |
| J7050 |
Normal saline solution infus |
1,063 |
856 |
$21.83 |
| J7030 |
Normal saline solution infus |
599 |
458 |
$14.37 |
| J7120 |
Ringers lactate infusion |
1,123 |
925 |
$0.57 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
173 |
142 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
38 |
25 |
$0.00 |
| G1004 |
Cdsm ndsc |
22 |
13 |
$0.00 |
| 83605 |
|
66 |
41 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
48 |
25 |
$0.00 |
| 83690 |
|
26 |
24 |
$0.00 |
| 71045 |
|
70 |
65 |
$0.00 |
| 84703 |
|
70 |
65 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
18 |
15 |
$0.00 |
| 88305 |
|
24 |
12 |
$0.00 |