INTERMOUNTAIN EAR,NOSE, AND THROAT SPECIALISTS LLC
NPI: 1487764411
· SALT LAKE CITY, UT 84102
· Medical Specialty Clinic/Center
· NPI assigned 08/31/2006
$162K
Total Medicaid Paid
Provider Details
| Authorized Official | PEFAUR, EVON (BILLING MANAGER) |
| NPI Enumeration Date | 08/31/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
54 |
$1K |
| 2020 |
14 |
$0.00 |
| 2021 |
72 |
$3K |
| 2022 |
119 |
$8K |
| 2023 |
1,639 |
$79K |
| 2024 |
1,271 |
$70K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
608 |
589 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
704 |
657 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
428 |
399 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
464 |
435 |
$27K |
| 92557 |
|
353 |
342 |
$7K |
| 92504 |
|
100 |
91 |
$6K |
| 92550 |
|
317 |
308 |
$2K |
| 70486 |
|
13 |
12 |
$2K |
| 92567 |
|
81 |
79 |
$862.64 |
| 92588 |
|
14 |
14 |
$297.50 |
| 69210 |
|
12 |
12 |
$196.30 |
| 95115 |
|
32 |
13 |
$151.74 |
| 99072 |
|
43 |
40 |
$61.28 |