SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE
NPI: 1871546259
· SUBLETTE, KS 67877
· Public Health or Welfare Agency
· NPI assigned 05/18/2006
Provider Details
| Authorized Official | PENDERGRAFT, TINA (ADMINISTRATOR) |
| Parent Organization | SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE |
| NPI Enumeration Date | 05/18/2006 |
Related Entities
Other providers sharing the same authorized official: PENDERGRAFT, TINA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
184 |
$3K |
| 2019 |
260 |
$3K |
| 2020 |
128 |
$1K |
| 2021 |
90 |
$868.30 |
| 2022 |
56 |
$633.38 |
| 2023 |
35 |
$393.50 |
| 2024 |
23 |
$300.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
447 |
380 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
56 |
52 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$436.82 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21 |
20 |
$360.00 |
| 90686 |
|
142 |
137 |
$164.72 |
| 85018 |
|
27 |
27 |
$8.04 |
| 90715 |
|
13 |
12 |
$0.00 |
| 90734 |
|
18 |
17 |
$0.00 |
| 90461 |
|
23 |
14 |
$0.00 |
| 90651 |
|
15 |
13 |
$0.00 |