BLACK CANYON MEDICAL GROUP PLLC
NPI: 1811419708
· EMMETT, ID 83617
· 207Q00000X
$371K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
804 |
$37K |
| 2019 |
642 |
$30K |
| 2020 |
914 |
$43K |
| 2021 |
1,449 |
$72K |
| 2022 |
1,247 |
$68K |
| 2023 |
956 |
$66K |
| 2024 |
738 |
$55K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
3,609 |
3,396 |
$228K |
| 99214 |
|
1,407 |
1,351 |
$120K |
| 99212 |
|
260 |
251 |
$9K |
| 36415 |
|
971 |
919 |
$3K |
| 90471 |
|
139 |
138 |
$3K |
| 99391 |
|
24 |
24 |
$2K |
| 90674 |
|
78 |
78 |
$2K |
| 96372 |
|
84 |
75 |
$1K |
| 99392 |
|
12 |
12 |
$1K |
| G0008 |
Admin influenza virus vac |
74 |
68 |
$931.61 |
| 87811 |
|
14 |
14 |
$484.12 |
| 90686 |
|
34 |
33 |
$479.64 |
| 90472 |
|
15 |
13 |
$302.00 |
| 81002 |
|
14 |
14 |
$37.60 |
| J1885 |
Ketorolac tromethamine inj |
15 |
12 |
$29.33 |