LIBERTY DIALYSIS-ST.GEORGE LLC
NPI: 1861671422
· ST GEORGE, UT 84790
· 261QE0700X
$155K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,949 |
$35K |
| 2019 |
523 |
$2K |
| 2020 |
581 |
$3K |
| 2021 |
4,754 |
$66K |
| 2022 |
3,271 |
$49K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4657 |
Syringe w/wo needle |
1,460 |
187 |
$57K |
| 90999 |
|
4,867 |
360 |
$40K |
| 83550 |
|
688 |
637 |
$17K |
| 84520 |
|
728 |
512 |
$11K |
| 85018 |
|
580 |
293 |
$9K |
| 84155 |
|
683 |
634 |
$7K |
| 83970 |
|
250 |
228 |
$5K |
| J3490 |
Drugs unclassified injection |
81 |
12 |
$4K |
| 82728 |
|
252 |
231 |
$1K |
| 85025 |
|
649 |
602 |
$1K |
| 82040 |
|
27 |
25 |
$631.78 |
| 82310 |
|
27 |
25 |
$528.71 |
| 87340 |
|
412 |
382 |
$486.81 |
| J0887 |
Epoetin beta esrd use |
33 |
25 |
$279.36 |
| 83540 |
|
693 |
643 |
$240.27 |
| J1756 |
Iron sucrose injection |
226 |
91 |
$0.00 |
| 84100 |
|
27 |
25 |
$0.00 |
| 82746 |
|
15 |
14 |
$0.00 |
| 80069 |
|
156 |
148 |
$0.00 |
| 84075 |
|
84 |
79 |
$0.00 |
| 86706 |
|
47 |
44 |
$0.00 |
| G0008 |
Admin influenza virus vac |
37 |
31 |
$0.00 |
| 90686 |
|
17 |
15 |
$0.00 |
| 80051 |
|
27 |
25 |
$0.00 |
| 82607 |
|
12 |
12 |
$0.00 |