SOUTHERN LIGHT RESIDENTIAL
NPI: 1801312459
· BOLIVAR, MO 65613
· 101YP2500X
$173K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,263 |
$99K |
| 2019 |
2,654 |
$74K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90853 |
|
3,880 |
1,273 |
$89K |
| 90834 |
|
1,907 |
546 |
$82K |
| 90832 |
|
116 |
31 |
$1K |
| 90791 |
|
14 |
13 |
$531.30 |