BURN AND RECONSTRUCTIVE CENTERS OF IDAHO, PLLC
NPI: 1902360639
· IDAHO FALLS, ID 83404
· Specialist
· NPI assigned 01/28/2019
$178K
Total Medicaid Paid
Provider Details
| Authorized Official | FAGAN, SHAWN (OWNER/MD) |
| NPI Enumeration Date | 01/28/2019 |
Related Entities
Other providers sharing the same authorized official: FAGAN, SHAWN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
1,257 |
$19K |
| 2020 |
1,949 |
$51K |
| 2021 |
2,171 |
$56K |
| 2022 |
1,574 |
$52K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,984 |
2,778 |
$144K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
728 |
493 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
54 |
51 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
185 |
130 |
$3K |