CROCKETT MEDICAL CENTER, LLC
NPI: 1003303983
· CROCKETT, TX 75835
· Rural Health Clinic/Center
· NPI assigned 04/17/2018
$185K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: TJELMELAND, KELLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
555 |
$2K |
| 2022 |
844 |
$22K |
| 2023 |
789 |
$44K |
| 2024 |
392 |
$117K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,310 |
1,747 |
$183K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
47 |
38 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
164 |
112 |
$310.04 |
| 90461 |
|
59 |
31 |
$66.83 |