LIBERTY DIALYSIS - IDAHO FALLS LLC
NPI: 1487692950
· IDAHO FALLS, ID 83404
· 261QE0700X
$668K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
11,471 |
$182K |
| 2019 |
12,636 |
$235K |
| 2020 |
5,838 |
$167K |
| 2021 |
12,866 |
$52K |
| 2022 |
5,201 |
$31K |
| 2023 |
357 |
$888.94 |
| 2024 |
583 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
19,583 |
1,540 |
$617K |
| J0887 |
Epoetin beta esrd use |
671 |
434 |
$32K |
| A4657 |
Syringe w/wo needle |
5,481 |
525 |
$9K |
| 84520 |
|
2,593 |
1,231 |
$2K |
| 84100 |
|
1,573 |
1,277 |
$2K |
| 87340 |
|
1,411 |
1,266 |
$1K |
| 83540 |
|
1,430 |
1,275 |
$1K |
| 82310 |
|
1,541 |
1,275 |
$1K |
| 82040 |
|
1,455 |
1,276 |
$1K |
| 84155 |
|
1,386 |
1,238 |
$1K |
| J1756 |
Iron sucrose injection |
398 |
93 |
$972.37 |
| 82565 |
|
1,361 |
1,211 |
$963.17 |
| 83550 |
|
933 |
825 |
$917.16 |
| 83970 |
|
469 |
418 |
$445.83 |
| 82728 |
|
485 |
430 |
$277.54 |
| 84075 |
|
461 |
413 |
$229.72 |
| 83735 |
|
168 |
148 |
$170.03 |
| 86706 |
|
130 |
118 |
$107.48 |
| G0008 |
Admin influenza virus vac |
35 |
34 |
$56.11 |
| 90688 |
|
15 |
15 |
$40.35 |
| 84466 |
|
307 |
279 |
$32.84 |
| 85025 |
|
1,373 |
1,226 |
$0.00 |
| 86803 |
|
29 |
26 |
$0.00 |
| 85046 |
|
630 |
549 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
976 |
48 |
$0.00 |
| 85018 |
|
2,642 |
1,017 |
$-466.11 |
| 80051 |
|
1,416 |
1,261 |
$-1950.69 |