SAN JUAN COUNTY HOSPITAL
NPI: 1588978738
· SPANISH VALLEY, UT 84532
· Family Medicine Physician
· NPI assigned 07/29/2010
$108K
Total Medicaid Paid
Provider Details
| Authorized Official | HOLT, CLAYTON (CEO) |
| Parent Organization | SAN JUAN COUNTY HOSPITAL |
| NPI Enumeration Date | 07/29/2010 |
Related Entities
Other providers sharing the same authorized official: HOLT, CLAYTON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
517 |
$35K |
| 2023 |
837 |
$40K |
| 2024 |
438 |
$34K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
754 |
585 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
521 |
462 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
505 |
441 |
$32K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$778.56 |