WHITE OAK MEDICAL CLINIC LLC
NPI: 1205305190
· ROSEBURG, OR 97471
· Family Medicine Physician
· NPI assigned 11/20/2018
$662K
Total Medicaid Paid
Provider Details
| Authorized Official | BOLDUC, DIANE (PRESIDENT) |
| NPI Enumeration Date | 11/20/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
1,367 |
$83K |
| 2020 |
2,005 |
$113K |
| 2021 |
3,243 |
$118K |
| 2022 |
2,809 |
$136K |
| 2023 |
2,336 |
$125K |
| 2024 |
1,399 |
$87K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,872 |
4,357 |
$353K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,005 |
5,329 |
$305K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
118 |
84 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
54 |
51 |
$400.11 |
| 96127 |
|
97 |
92 |
$351.18 |
| 99408 |
|
13 |
13 |
$45.00 |