Clinic
Srs-Provo, LLC
Srs-Provo, LLC was paid $12K by Medicaid between Oct 2022 and Nov 2022, across 2 billing codes. Its largest line is 90999, dialysis (unlisted procedure) — 77% of everything it billed.
33Billing provider infoSRS-PROVO, LLC
PROVO, UT 84604
PROVO, UT 84604
33aNPI1679147904assigned 05/20/2021
33bProvider typeEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
28Total paid$12K
24GClaims82
24DCodes billed2
24AFirst – last monthOct 2022 – Nov 2022
Compared with peers
Next to other End-Stage Renal Disease (ESRD) Treatment Clinic/Center providers in Utah
Rank by total paid#34 of 43
Median peer was paid$240K
This provider vs. median0.1×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2022 | 82 | $12K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90999 | Dialysis (unlisted procedure)Unlisted dialysis procedure, inpatient or outpatient | 77% | 55 | 26 | $10K |
| A4657 | Syringe, with or without needle, each | 23% | 27 | 13 | $3K |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialTANNENBAUM, JEROME (CEO AND CHAIRMAN OF THE BOARD)
| Provider | Location | Paid |
|---|---|---|
| SRS - Tehachapi LLC | Tehachapi, CA | $1.64M |
| Srs-Nashville HH LLC | Nashville, TN | $830K |
| Srs-Ridgecrest | Ridgecrest, CA | $156K |
| National Tele-Nephrology Associates PC | Nashville, TN | $3K |
| Srs-San Diego LLC | Chula Vista, CA | $3K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.