SALUD INTEGRAL EN LA MONTANA, INC
NPI: 1619458445
· COMERIO, PR 00782
· 261Q00000X
$407K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,172 |
$6K |
| 2021 |
16,671 |
$221K |
| 2022 |
6,119 |
$58K |
| 2023 |
3,831 |
$79K |
| 2024 |
3,804 |
$43K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0002A |
|
2,201 |
2,175 |
$71K |
| 90471 |
|
6,003 |
5,059 |
$59K |
| 0001A |
|
2,366 |
2,325 |
$47K |
| 90472 |
|
2,461 |
2,099 |
$31K |
| 0012A |
|
834 |
803 |
$30K |
| 0011A |
|
777 |
762 |
$25K |
| 90651 |
|
595 |
534 |
$16K |
| 0064A |
|
462 |
404 |
$16K |
| 90686 |
|
2,133 |
1,935 |
$15K |
| 0071A |
|
313 |
311 |
$12K |
| 0072A |
|
285 |
283 |
$11K |
| 0004A |
|
327 |
270 |
$11K |
| 90620 |
|
628 |
528 |
$11K |
| 90734 |
|
358 |
319 |
$10K |
| 90656 |
|
611 |
347 |
$9K |
| 0054A |
|
615 |
542 |
$7K |
| 0124A |
|
170 |
140 |
$6K |
| 90670 |
|
366 |
314 |
$5K |
| 91320 |
|
42 |
28 |
$4K |
| 90677 |
|
175 |
161 |
$3K |
| 90674 |
|
103 |
100 |
$2K |
| 91307 |
|
643 |
585 |
$2K |
| 90480 |
|
43 |
29 |
$2K |
| 0074A |
|
27 |
27 |
$1K |
| 0134A |
|
17 |
17 |
$680.00 |
| 0081A |
|
12 |
12 |
$480.00 |
| 90715 |
|
136 |
127 |
$376.32 |
| 90732 |
|
13 |
12 |
$342.63 |
| 90648 |
|
107 |
94 |
$341.92 |
| 90716 |
|
180 |
165 |
$266.90 |
| 90707 |
|
154 |
139 |
$197.75 |
| 90633 |
|
224 |
214 |
$187.20 |
| 90657 |
|
103 |
97 |
$63.65 |
| 90655 |
|
82 |
75 |
$16.00 |
| 91306 |
|
464 |
406 |
$0.40 |
| 91300 |
|
5,233 |
4,552 |
$0.02 |
| G0008 |
Admin influenza virus vac |
68 |
52 |
$0.00 |
| 91305 |
|
281 |
275 |
$0.00 |
| 90619 |
|
135 |
130 |
$0.00 |
| 91301 |
|
1,624 |
1,573 |
$0.00 |
| 91308 |
|
39 |
39 |
$0.00 |
| 91312 |
|
170 |
140 |
$0.00 |
| 91313 |
|
17 |
17 |
$0.00 |