NPI: 1619447653 · SANTA CLARA, UT 84765 · Ambulance · NPI assigned 12/03/2018
| Authorized Official | JACOBSEN, BROCK (FINANCE DIRECTOR) |
| NPI Enumeration Date | 12/03/2018 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 21 | $314.82 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 21 | 15 | $314.82 |