CLACKAMAS COUNTY
NPI: 1043566847
· SANDY, OR 97055
· Federally Qualified Health Center (FQHC)
· NPI assigned 07/30/2012
$367K
Total Medicaid Paid
Provider Details
| Authorized Official | JACOBSON, SARAH (DIRECTOR - INTERIM) |
| NPI Enumeration Date | 07/30/2012 |
Related Entities
Other providers sharing the same authorized official: JACOBSON, SARAH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
53 |
$826.40 |
| 2021 |
734 |
$49K |
| 2022 |
1,351 |
$107K |
| 2023 |
1,597 |
$121K |
| 2024 |
1,208 |
$90K |
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 |
2,169 |
1,894 |
$197K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,196 |
1,954 |
$148K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
142 |
124 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
194 |
188 |
$3K |
| 90674 |
|
114 |
112 |
$2K |
| 0012A |
|
16 |
16 |
$425.85 |
| 36416 |
|
77 |
71 |
$196.87 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
35 |
28 |
$97.92 |