MARILLAC CLINIC, INC.
NPI: 1093345886
· GRAND JUNCTION, CO 81504
· Federally Qualified Health Center (FQHC)
· NPI assigned 01/21/2020
$222K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: RAMACHANDRAN, LATA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
3,605 |
$169K |
| 2024 |
1,486 |
$53K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
410 |
293 |
$122K |
| 90834 |
Psychotherapy, 45 minutes with patient |
414 |
255 |
$56K |
| 1036F |
|
133 |
108 |
$18K |
| 1159F |
|
354 |
253 |
$14K |
| 2000F |
|
575 |
425 |
$12K |
| 2001F |
|
547 |
413 |
$349.29 |
| 3008F |
|
531 |
404 |
$0.00 |
| 3079F |
|
45 |
37 |
$0.00 |
| 2010F |
|
583 |
432 |
$0.00 |
| 3074F |
|
374 |
286 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
205 |
132 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17 |
13 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
67 |
55 |
$0.00 |
| 97802 |
|
47 |
46 |
$0.00 |
| 3075F |
|
19 |
17 |
$0.00 |
| 99080 |
|
37 |
32 |
$0.00 |
| 1160F |
|
354 |
253 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
49 |
38 |
$0.00 |
| 3078F |
|
330 |
263 |
$0.00 |