COUNTY OF COSTILLA
NPI: 1972725455
· SAN LUIS, CO 81152
· Case Management Agency
· NPI assigned 05/03/2007
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
244 |
$3K |
| 2019 |
132 |
$2K |
| 2020 |
74 |
$927.62 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
273 |
266 |
$5K |
| 90658 |
|
148 |
148 |
$697.44 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$230.79 |
| 90656 |
|
17 |
17 |
$0.00 |