ST. CROIX REGIONAL MEDICAL CENTER
NPI: 1013423219
· BALSAM LAKE, WI 54810
· Rural Health Clinic/Center
· NPI assigned 12/26/2017
$311K
Total Medicaid Paid
Provider Details
| Authorized Official | YOUSO, MIKE (CFO) |
| NPI Enumeration Date | 12/26/2017 |
Related Entities
Other providers sharing the same authorized official: YOUSO, MIKE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
536 |
$23K |
| 2020 |
915 |
$42K |
| 2021 |
1,220 |
$52K |
| 2022 |
952 |
$50K |
| 2023 |
1,736 |
$69K |
| 2024 |
1,485 |
$75K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,002 |
3,712 |
$215K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,986 |
1,786 |
$72K |
| 99215 |
Prolong outpt/office vis |
228 |
200 |
$14K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
255 |
202 |
$8K |
| 99441 |
|
111 |
101 |
$988.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
24 |
$391.68 |
| 90686 |
|
17 |
17 |
$344.40 |
| 36415 |
Collection of venous blood by venipuncture |
220 |
191 |
$0.00 |