Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › UT › PROVO › SRS-PROVO, LLC

SRS-PROVO, LLC

NPI: 1679147904 · PROVO, UT 84604 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI assigned 05/20/2021

$12K
Total Medicaid Paid
82
Total Claims
39
Beneficiaries
2
Codes Billed
2022-10
First Month
2022-11
Last Month

Provider Details

Authorized OfficialTANNENBAUM, JEROME (CEO AND CHAIRMAN OF THE BOARD)
NPI Enumeration Date05/20/2021

Related Entities

Other providers sharing the same authorized official: TANNENBAUM, JEROME

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 82 $12K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90999 Unlisted dialysis procedure, inpatient or outpatient 55 26 $10K
A4657 Syringe, with or without needle, each 27 13 $3K