Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WI › SIREN › INDIANHEAD MEDICAL CENTER SHELL LAKE, INC.

INDIANHEAD MEDICAL CENTER SHELL LAKE, INC.

NPI: 1053859058 · SIREN, WI 54872 · Primary Care Clinic/Center · NPI assigned 02/09/2017

$4K
Total Medicaid Paid
155
Total Claims
132
Beneficiaries
3
Codes Billed
2018-01
First Month
2021-03
Last Month

Provider Details

Authorized OfficialJACK, SHANNON (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date02/09/2017

Related Entities

Other providers sharing the same authorized official: JACK, SHANNON

ProviderCityStateTotal Paid
INDIANHEAD MEDICAL CENTER SHELL LAKE, INC SHELL LAKE WI $501K
INDIANHEAD MEDICAL CENTER SHELL LAKE, INC. SHELL LAKE WI $153K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 44 $589.13
2019 31 $1K
2020 64 $2K
2021 16 $462.92

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 107 87 $2K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 36 33 $2K
90688 12 12 $113.17