COUNTY LINE HEALTH CLINIC

$66K

Total Medicaid Paid

1,140

Total Claims

1,019

Beneficiaries

4

Codes Billed

2022-01

First Month

2024-10

Last Month

Authorized Official	CASPER, SHELBY (OWNER)
NPI Enumeration Date	08/30/2021

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	686	606	$37K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	365	337	$24K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	54	49	$3K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	35	27	$2K

Medicaid Provider Spending