SAINT ALPHONSUS MEDICAL CENTER- ONTARIO INC
NPI: 1760823397
· FRUITLAND, ID 83619
· 261QR1300X
$856K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,597 |
$66K |
| 2019 |
1,744 |
$72K |
| 2020 |
1,832 |
$107K |
| 2021 |
2,512 |
$144K |
| 2022 |
2,998 |
$168K |
| 2023 |
3,005 |
$155K |
| 2024 |
2,702 |
$144K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
7,738 |
7,228 |
$735K |
| 99213 |
|
4,768 |
4,296 |
$82K |
| 99214 |
|
2,692 |
2,185 |
$30K |
| 99204 |
|
24 |
24 |
$3K |
| 20610 |
|
55 |
55 |
$3K |
| 99203 |
|
210 |
204 |
$2K |
| 99202 |
|
37 |
33 |
$721.23 |
| 87428 |
|
28 |
28 |
$259.92 |
| J3301 |
Triamcinolone acet inj nos |
13 |
13 |
$90.71 |
| G2211 |
Complex e/m visit add on |
142 |
125 |
$75.81 |
| 87880 |
|
25 |
25 |
$34.71 |
| 3074F |
|
309 |
298 |
$0.00 |
| 87426 |
|
19 |
19 |
$0.00 |
| 3079F |
|
24 |
24 |
$0.00 |
| 0011A |
|
12 |
12 |
$0.00 |
| 3078F |
|
294 |
284 |
$0.00 |