INDIANA IMMUNIZATION COALITION INC
NPI: 1598389991
· INDIANAPOLIS, IN 46219
· Public Health or Welfare Agency
· NPI assigned 06/01/2020
$128K
Total Medicaid Paid
8,242
Beneficiary Records
Provider Details
| Authorized Official | ROBERTSON, LISA (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 06/01/2020 |
Related Entities
Other providers sharing the same authorized official: ROBERTSON, LISA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
17,178 |
$128K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 90651 |
|
1,257 |
724 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,339 |
1,040 |
$28K |
| 90461 |
|
2,253 |
669 |
$12K |
| 90710 |
|
434 |
245 |
$9K |
| 90620 |
|
601 |
366 |
$9K |
| 90734 |
|
1,267 |
767 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,924 |
700 |
$5K |
| 90715 |
|
1,054 |
616 |
$4K |
| 90716 |
|
208 |
159 |
$4K |
| 90677 |
|
77 |
69 |
$3K |
| 90619 |
|
140 |
45 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
913 |
854 |
$3K |
| 91322 |
|
117 |
78 |
$2K |
| 90739 |
|
15 |
13 |
$2K |
| 90656 |
|
585 |
544 |
$1K |
| 90713 |
|
387 |
258 |
$1K |
| 91320 |
|
137 |
118 |
$1K |
| 90632 |
|
19 |
16 |
$985.56 |
| 90707 |
|
148 |
113 |
$947.50 |
| 90621 |
|
12 |
12 |
$795.96 |
| 90723 |
|
45 |
36 |
$692.51 |
| 90744 |
|
307 |
176 |
$316.51 |
| 90662 |
|
26 |
25 |
$133.90 |
| 90696 |
|
179 |
103 |
$0.00 |
| 91319 |
|
27 |
20 |
$0.00 |
| 90633 |
|
556 |
359 |
$0.00 |
| 90661 |
|
36 |
34 |
$0.00 |
| 91321 |
|
94 |
67 |
$0.00 |
| 90700 |
|
21 |
16 |
$0.00 |