SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
NPI: 1760576714
· KALISPELL, MT 59901
· 163WI0500X
$359K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
141 |
$10K |
| 2020 |
422 |
$52K |
| 2021 |
550 |
$43K |
| 2022 |
1,178 |
$91K |
| 2023 |
1,078 |
$91K |
| 2024 |
832 |
$72K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99601 |
|
3,335 |
1,685 |
$242K |
| S9379 |
Hit noc per diem |
828 |
558 |
$89K |
| S9500 |
Hit antibiotic q24h diem |
25 |
13 |
$24K |
| B4035 |
Enteral feed supp pump per d |
13 |
12 |
$3K |