Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

CCRC - LAKE PORT SQUARE, LLC

NPI: 1073927331 · LEESBURG, FL 34748 · Skilled Nursing Facility · NPI assigned 06/16/2014

$5K
Total Medicaid Paid
118
Total Claims
12
Beneficiaries
1
Codes Billed
2019-02
First Month
2019-02
Last Month

Provider Details

Authorized OfficialMOHADEO, TRISTAN (ADMINISTRATOR)
NPI Enumeration Date06/16/2014

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 118 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
97530 Therapeutic activities, direct patient contact, each 15 minutes 118 12 $5K