Clinic
County of Teton
County of Teton was paid $628.58 by Medicaid between Oct 2020 and Oct 2024, across 5 billing codes. Its largest line is 90460, Immunization administration through 18 years of age via any route, first or only component — 80% of everything it billed.
33Billing provider infoCOUNTY OF TETON
JACKSON, WY 83001
JACKSON, WY 83001
33aNPI1952334393assigned 07/09/2006
33bProvider typeState or Local Public Health Clinic/Center
28Total paid$628.58
24GClaims128
24DCodes billed5
24AFirst – last monthOct 2020 – Oct 2024
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2020 | 16 | $0.00 | |
| 2021 | 39 | $180.00 | |
| 2022 | 58 | $431.30 | |
| 2024incomplete | 15 | $17.28 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 80% | 43 | 36 | $500.00 |
| 90686 | 18% | 37 | 37 | $111.30 | |
| 90656 | 2.7% | 15 | 14 | $17.28 | |
| 90658 | 0% | 17 | 13 | $0.00 | |
| 90461 | 0% | 16 | 16 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialRIDDELL, TRAVIS (DIRECTOR OF HEALTH)
| Provider | Location | Paid |
|---|---|---|
| Jackson Pediatric Associates, LLC | Jackson, WY | $15K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.