CROSS TRAILS MEDICAL CENTER
NPI: 1225191752
· ADVANCE, MO 63730
· Federally Qualified Health Center (FQHC)
· NPI assigned 12/18/2006
$141K
Total Medicaid Paid
Provider Details
| Authorized Official | WELLS, MONA (CFO) |
| Parent Organization | CROSS TRAILS MEDICAL CENTER |
| NPI Enumeration Date | 12/18/2006 |
Related Entities
Other providers sharing the same authorized official: WELLS, MONA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
879 |
$25K |
| 2019 |
880 |
$24K |
| 2020 |
445 |
$13K |
| 2021 |
550 |
$22K |
| 2022 |
512 |
$22K |
| 2023 |
527 |
$25K |
| 2024 |
193 |
$10K |
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 |
1,700 |
1,550 |
$105K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
837 |
762 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
281 |
254 |
$15K |
| 0012A |
|
14 |
14 |
$373.52 |
| 0011A |
|
15 |
13 |
$203.32 |
| 90688 |
|
31 |
28 |
$179.40 |
| 90674 |
|
44 |
29 |
$58.88 |
| 36415 |
Collection of venous blood by venipuncture |
1,064 |
991 |
$0.00 |