Clinic
White Earth Indian Health Center
White Earth Indian Health Center was paid $24.32M by Medicaid between Jan 2018 and Dec 2024, across 129 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 36% of everything it billed.
33Billing provider infoWHITE EARTH INDIAN HEALTH CENTER
OGEMA, MN 56569
OGEMA, MN 56569
33aNPI1093761710assigned 05/25/2006
33bProvider typeFederal Public Health Clinic/Center
28Total paid$24.32M
24GClaims136,260
24DCodes billed129
24AFirst – last monthJan 2018 – Dec 2024
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 29,155 | $3.58M | |
| 2019 | 28,358 | $4.03M | |
| 2020 | 20,145 | $3.30M | |
| 2021 | 24,465 | $4.49M | |
| 2022 | 18,454 | $4.14M | |
| 2023 | 9,369 | $2.65M | |
| 2024incomplete | 6,314 | $2.12M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 36% | 22,135 | 18,732 | $8.76M |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 12% | 7,169 | 5,973 | $3.01M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 8.2% | 4,953 | 4,438 | $1.99M |
| D0140 | Limited oral evaluation - problem focused | 5.0% | 3,627 | 3,057 | $1.22M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 3.5% | 2,290 | 1,953 | $849K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 3.0% | 2,202 | 824 | $718K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.5% | 4,250 | 3,273 | $620K |
| D1206 | Topical application of fluoride varnish | 2.5% | 7,501 | 6,209 | $606K |
| D0220 | Intraoral - periapical first radiographic image | 2.3% | 4,677 | 3,784 | $551K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.1% | 2,637 | 2,095 | $509K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 1.9% | 1,152 | 1,076 | $452K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.4% | 1,164 | 1,053 | $341K |
117 more codes
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 1.2% | 715 | $297K |
| D0274 | Bitewings - four radiographic images | 1.0% | 2,168 | $254K |
| 90670 | 1.0% | 1,157 | $251K | |
| D1110 | Prophylaxis - adult | <1% | 1,693 | $241K |
| 99442 | <1% | 596 | $239K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 503 | $228K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 3,028 | $224K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,146 | $184K |
| D1351 | Sealant - per tooth | <1% | 5,881 | $180K |
| 92015 | Determination of refractive state | <1% | 2,894 | $167K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 832 | $154K |
| 99441 | <1% | 313 | $153K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 376 | $135K |
| D0330 | Panoramic radiographic image | <1% | 1,126 | $115K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 259 | $109K |
| D1330 | <1% | 499 | $105K | |
| 90710 | <1% | 344 | $101K | |
| 99173 | <1% | 225 | $93K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 893 | $91K |
| 99443 | <1% | 181 | $90K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 369 | $87K |
| D0272 | Bitewings - two radiographic images | <1% | 1,119 | $85K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 717 | $83K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 244 | $71K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 2,543 | $60K |
| 0011A | <1% | 146 | $59K | |
| 0012A | <1% | 134 | $58K | |
| 0001A | <1% | 150 | $58K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 170 | $56K |
| 0002A | <1% | 116 | $56K | |
| 94760 | <1% | 570 | $51K | |
| 99188 | <1% | 1,064 | $48K | |
| 99406 | <1% | 209 | $43K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 691 | $42K |
| 99606 | <1% | 120 | $40K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 293 | $34K |
| 96127 | <1% | 120 | $33K | |
| 90651 | <1% | 194 | $31K | |
| 0071A | <1% | 62 | $30K | |
| 0064A | <1% | 104 | $29K | |
| 92551 | <1% | 65 | $29K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 681 | $28K |
| 90734 | <1% | 177 | $20K | |
| 0072A | <1% | 32 | $18K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 2,289 | $16K |
| 90686 | <1% | 462 | $14K | |
| 97161 | <1% | 25 | $12K | |
| 90633 | <1% | 359 | $10K | |
| 90461 | <1% | 1,917 | $10K | |
| D2940 | <1% | 387 | $10K | |
| 92002 | <1% | 15 | $9K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 15 | $7K |
| 90750 | <1% | 26 | $7K | |
| D2140 | <1% | 44 | $6K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 48 | $6K |
| D0270 | <1% | 90 | $5K | |
| D1354 | <1% | 74 | $5K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 14 | $5K |
| D2331 | <1% | 26 | $3K | |
| 90723 | <1% | 739 | $3K | |
| 92552 | <1% | 26 | $3K | |
| 96160 | <1% | 16 | $2K | |
| 90715 | <1% | 14 | $854.00 | |
| 92285 | <1% | 13 | $854.00 | |
| 99177 | <1% | 60 | $427.00 | |
| 96161 | <1% | 29 | $427.00 | |
| Q3014 | Telehealth originating site facility fee | <1% | 39 | $211.99 |
| 36415 | Collection of venous blood by venipuncture | <1% | 7,875 | $50.23 |
| 80053 | Comprehensive metabolic panel | <1% | 2,723 | $21.43 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 3,247 | $10.00 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 2,983 | $7.77 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 1,148 | $0.00 |
| 86703 | 0% | 918 | $0.00 | |
| 84439 | 0% | 609 | $0.00 | |
| 80061 | Lipid panel | 0% | 1,322 | $0.00 |
| 81025 | 0% | 729 | $0.00 | |
| 80305 | 0% | 369 | $0.00 | |
| 83718 | 0% | 32 | $0.00 | |
| D4341 | 0% | 26 | $0.00 | |
| 81003 | 0% | 642 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 666 | $0.00 |
| 82570 | 0% | 185 | $0.00 | |
| 82465 | 0% | 33 | $0.00 | |
| D0190 | 0% | 115 | $0.00 | |
| 83655 | 0% | 12 | $0.00 | |
| 71046 | Radiologic examination, chest; 2 views | 0% | 46 | $0.00 |
| D9330 | 0% | 19 | $0.00 | |
| 90700 | 0% | 28 | $0.00 | |
| D0460 | 0% | 14 | $0.00 | |
| 87210 | 0% | 31 | $0.00 | |
| D0191 | 0% | 63 | $0.00 | |
| 90473 | 0% | 14 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 14 | $0.00 |
| 90672 | 0% | 17 | $0.00 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 0% | 3,253 | $0.00 |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 0% | 170 | $0.00 |
| 86803 | 0% | 133 | $0.00 | |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 1,329 | $0.00 |
| 90647 | 0% | 741 | $0.00 | |
| 90680 | 0% | 300 | $0.00 | |
| DIH01 | 0% | 24 | $0.00 | |
| 92583 | 0% | 13 | $0.00 | |
| 81000 | 0% | 47 | $0.00 | |
| 82043 | 0% | 160 | $0.00 | |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 220 | $0.00 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 69 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 105 | $0.00 |
| 82044 | 0% | 74 | $0.00 | |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 0% | 183 | $0.00 |
| 92250 | 0% | 12 | $0.00 | |
| 93000 | 0% | 13 | $0.00 | |
| 90696 | 0% | 45 | $0.00 | |
| D1310 | 0% | 22 | $0.00 | |
| 85651 | 0% | 12 | $0.00 | |
| D0000 | 0% | 17 | $0.00 | |
| 82962 | 0% | 19 | $0.00 | |
| 36416 | 0% | 16 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialJACKSON, JOCELYN (ADMINISTRATIVE OFFICER)