MID-STATE HEALTH CENTER
NPI: 1235170549
· PLYMOUTH, NH 03264
· 103TC0700X
$5.47M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
10,767 |
$525K |
| 2019 |
11,479 |
$694K |
| 2020 |
10,435 |
$718K |
| 2021 |
12,784 |
$840K |
| 2022 |
11,211 |
$791K |
| 2023 |
8,853 |
$768K |
| 2024 |
11,722 |
$1.13M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
35,095 |
25,831 |
$5.37M |
| G0467 |
Fqhc visit, estab pt |
5,751 |
3,826 |
$41K |
| 99214 |
|
11,477 |
9,350 |
$23K |
| G2025 |
Dis site tele svcs rhc/fqhc |
591 |
350 |
$6K |
| H0015 |
Alcohol and/or drug services |
51 |
13 |
$5K |
| G2023 |
Specimen collect covid-19 |
292 |
223 |
$5K |
| G0470 |
Fqhc visit, mh estab pt |
743 |
337 |
$4K |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
803 |
610 |
$3K |
| 99213 |
|
6,724 |
5,500 |
$3K |
| 90834 |
|
4,927 |
2,922 |
$2K |
| 90460 |
|
951 |
767 |
$2K |
| 3074F |
|
1,259 |
1,092 |
$2K |
| 90832 |
|
3,369 |
2,091 |
$2K |
| 3078F |
|
1,023 |
893 |
$2K |
| 87426 |
|
32 |
24 |
$777.26 |
| 80305 |
|
106 |
72 |
$624.44 |
| 90686 |
|
750 |
624 |
$620.85 |
| G0071 |
Comm svcs by rhc/fqhc 5 min |
66 |
63 |
$574.57 |
| 92551 |
|
428 |
388 |
$260.28 |
| 3079F |
|
226 |
198 |
$214.39 |
| 99177 |
|
155 |
144 |
$139.81 |
| 90837 |
|
189 |
130 |
$118.38 |
| 90791 |
|
344 |
303 |
$93.35 |
| 90471 |
|
82 |
81 |
$53.20 |
| 36415 |
|
791 |
718 |
$50.51 |
| 3075F |
|
29 |
28 |
$50.00 |
| G0008 |
Admin influenza virus vac |
59 |
52 |
$27.47 |
| Q2039 |
Influenza virus vaccine, nos |
32 |
26 |
$27.45 |
| G0468 |
Fqhc visit, ippe or awv |
26 |
25 |
$16.10 |
| 90656 |
|
13 |
12 |
$14.54 |
| G2211 |
Complex e/m visit add on |
13 |
12 |
$9.68 |
| 36416 |
|
46 |
44 |
$1.58 |
| G0439 |
Ppps, subseq visit |
14 |
13 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
137 |
129 |
$0.00 |
| 99212 |
|
489 |
393 |
$0.00 |
| 99393 |
|
60 |
57 |
$0.00 |
| 99394 |
|
12 |
12 |
$0.00 |
| 99392 |
|
58 |
44 |
$0.00 |
| 90461 |
|
38 |
27 |
$0.00 |