ODESSA I ENTERPRISES, LLC
NPI: 1770143521
· ODESSA, TX 79762
· 314000000X
$813.14
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
3,616 |
$406.00 |
| 2022 |
1,466 |
$166.58 |
| 2023 |
1,220 |
$240.56 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97530 |
|
2,191 |
327 |
$646.56 |
| 97110 |
|
2,640 |
319 |
$166.58 |
| 97116 |
|
65 |
13 |
$0.00 |
| 97112 |
|
1,367 |
223 |
$0.00 |
| G0008 |
Admin influenza virus vac |
20 |
20 |
$0.00 |
| 90694 |
|
19 |
19 |
$0.00 |