Physician
Cleanslate Medical Group of Pennsylvania LLC
Cleanslate Medical Group of Pennsylvania LLC was paid $18.61M by Medicaid between Jan 2018 and Dec 2024, across 23 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 45% of everything it billed.
33Billing provider infoCLEANSLATE MEDICAL GROUP OF PENNSYLVANIA LLC
WILKES BARRE, PA 18702
WILKES BARRE, PA 18702
33aNPI1184177263assigned 07/26/2016
33bProvider typeAddiction Medicine (Internal Medicine) Physician
28Total paid$18.61M
24GClaims276,990
24DCodes billed23
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Addiction Medicine (Internal Medicine) Physician providers in Pennsylvania
Rank by total paid#1 of 14
Median peer was paid$239K
This provider vs. median78×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
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 | 3,912 | $5K | |
| 2019 | 739 | $2K | |
| 2020 | 14,875 | $1.09M | |
| 2021 | 70,765 | $5.37M | |
| 2022 | 74,487 | $5.14M | |
| 2023 | 61,078 | $3.97M | |
| 2024incomplete | 51,134 | $3.04M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 45% | 163,162 | 120,325 | $8.47M |
| G9012 | Other specified case management service not elsewhere classified | 37% | 25,701 | 25,575 | $6.83M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 11% | 61,980 | 50,702 | $2.10M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 3.7% | 11,288 | 5,925 | $689K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 1.1% | 3,167 | 2,650 | $198K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 944 | 787 | $67K |
| 99340 | <1% | 341 | 319 | $48K | |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 649 | 387 | $48K |
| T2023 | Targeted case management; per month | <1% | 441 | 441 | $44K |
| G9002 | Coordinated care fee, maintenance rate | <1% | 246 | 243 | $36K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 881 | 649 | $31K |
| 81025 | <1% | 5,182 | 4,821 | $19K |
11 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,705 | $17K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 212 | $5K |
| Q3014 | Telehealth originating site facility fee | <1% | 272 | $4K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 115 | $3K |
| T1016 | Case management, each 15 minutes | <1% | 126 | $2K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 24 | $690.69 |
| 99406 | <1% | 65 | $427.50 | |
| H2015 | Community support for mental illness or disability, per 15 minutes | <1% | 326 | $360.00 |
| 87340 | <1% | 12 | $171.49 | |
| H0038 | Self-help/peer services, per 15 minutes | <1% | 121 | $9.00 |
| 99205 | Prolong outpt/office vis | 0% | 30 | $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 officialSMOLAREK, MATTHEW (CFO)
| Provider | Location | Paid |
|---|---|---|
| Cleanslate Medical Group of Indiana LLC | Alexandria, IN | $79.21M |
| Total Wellness Centers, LLC | Holyoke, MA | $77.17M |
| Total Wellness Centers, LLC | West Springfield, MA | $38.42M |
| Cleanslate Medical Group of Wisconsin, SC | Glendale, WI | $17.13M |
| Cleanslate Medical Group of Kentucky PLLC | Louisville, KY | $10.48M |
| Cleanslate Medical Group of Ohio LLC | Moraine, OH | $9.53M |
| Cleanslate Medical Group of Virginia, LLC | Mechanicsville, VA | $4.28M |
| Cleanslate Medical Group of Arizona PLLC | Gilbert, AZ | $955K |
| Cleanslate Medical Group of Arizona PLLC | Phoenix, AZ | $248K |
| Cleanslate Medical Group of Arizona PLLC | Phoenix, AZ | $101K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.