Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

GRAND TETON SURGICAL CENTER LLC

NPI: 1841295227 · IDAHO FALLS, ID 83404 · Ambulatory Surgical Clinic/Center · NPI assigned 06/14/2005

$344K
Total Medicaid Paid
2,884
Total Claims
2,368
Beneficiaries
6
Codes Billed
2018-01
First Month
2020-10
Last Month

Provider Details

Authorized OfficialWELLARD, TERESA (DIRECTOR OF NURSING)
NPI Enumeration Date06/14/2005

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,088 $77K
2019 893 $97K
2020 903 $171K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,140 1,018 $187K
45380 Colonoscopy, flexible; with biopsy, single or multiple 635 576 $145K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 29 29 $9K
G8907 Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility 929 655 $2K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 20 12 $2K
G8918 Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis 131 78 $0.00