SIMPLE MEDICAID RIDE LLC
NPI: 1811699028
· PUEBLO, CO 81001
· Non-emergency Medical Transport (VAN)
· NPI assigned 03/21/2023
$203K
Total Medicaid Paid
Provider Details
| Authorized Official | KIDANE, SISAY (OWNER) |
| NPI Enumeration Date | 03/21/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
477 |
$203K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
239 |
88 |
$186K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
238 |
88 |
$18K |