Medicaid Provider Spending

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

MOONLIGHT MOUNTAIN RECOVERY, INC

NPI: 1861983413 · POCATELLO, ID 83201 · Mental Health Clinic/Center (Including Community Mental Health Center) · NPI assigned 05/18/2018

$17.64M
Total Medicaid Paid
55,986
Total Claims
9,095
Beneficiaries
12
Codes Billed
2023-03
First Month
2024-06
Last Month

Provider Details

Authorized OfficialMORDEN, WADE (OWNER)
NPI Enumeration Date05/18/2018

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 35,398 $11.81M
2024 20,588 $5.83M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0035 Mental health partial hospitalization, treatment, less than 24 hours 39,927 3,689 $16.01M
H0015 Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education 10,091 1,407 $1.32M
T1017 Targeted case management, each 15 minutes 2,338 1,533 $112K
90791 Psychiatric diagnostic evaluation 704 704 $90K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 786 660 $29K
90853 Group psychotherapy (other than of a multiple-family group) 1,083 346 $28K
H0038 Self-help/peer services, per 15 minutes 595 367 $26K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 267 215 $14K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 71 71 $9K
99215 Prolong outpt/office vis 32 31 $4K
90832 Psychotherapy, 30 minutes with patient 60 40 $3K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 32 32 $3K