GOOD SAMARITAN HOSPITAL CA LTD PTP
NPI: 1861108631
· ARVIN, CA 93203
· 261QR1300X
$1.01M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
30,793 |
$1.01M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
11,938 |
7,957 |
$903K |
| 96372 |
|
1,060 |
943 |
$20K |
| 99393 |
|
167 |
163 |
$19K |
| 99395 |
|
143 |
137 |
$18K |
| 99394 |
|
102 |
99 |
$13K |
| 87426 |
|
233 |
214 |
$8K |
| J3420 |
Vitamin b12 injection |
963 |
861 |
$6K |
| 99396 |
|
44 |
42 |
$5K |
| 99392 |
|
40 |
39 |
$5K |
| G2025 |
Dis site tele svcs rhc/fqhc |
70 |
47 |
$4K |
| 81025 |
|
620 |
574 |
$2K |
| 87880 |
|
288 |
272 |
$2K |
| 81003 |
|
843 |
802 |
$1K |
| 90657 |
|
39 |
38 |
$332.69 |
| 90686 |
|
21 |
19 |
$242.43 |
| 3078F |
|
2,729 |
2,320 |
$0.00 |
| 3077F |
|
433 |
386 |
$0.00 |
| 3008F |
|
4,543 |
3,772 |
$0.00 |
| 3075F |
|
623 |
576 |
$0.00 |
| 3074F |
|
3,245 |
2,749 |
$0.00 |
| 3080F |
|
276 |
252 |
$0.00 |
| 3079F |
|
1,332 |
1,201 |
$0.00 |
| 3048F |
|
350 |
333 |
$0.00 |
| 3049F |
|
85 |
82 |
$0.00 |
| 3044F |
|
606 |
584 |
$0.00 |