COUNTY OF TETON
NPI: 1952334393
· JACKSON, WY 83001
· State or Local Public Health Clinic/Center
· NPI assigned 07/09/2006
$628.58
Total Medicaid Paid
Provider Details
| Authorized Official | RIDDELL, TRAVIS (DIRECTOR OF HEALTH) |
| NPI Enumeration Date | 07/09/2006 |
Related Entities
Other providers sharing the same authorized official: RIDDELL, TRAVIS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
16 |
$0.00 |
| 2021 |
39 |
$180.00 |
| 2022 |
58 |
$431.30 |
| 2024 |
15 |
$17.28 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
36 |
$500.00 |
| 90686 |
|
37 |
37 |
$111.30 |
| 90656 |
|
15 |
14 |
$17.28 |
| 90658 |
|
17 |
13 |
$0.00 |
| 90461 |
|
16 |
16 |
$0.00 |