OCEAN STATE URGENT CARE CENTER OF WESTERLY, LLC

NPI: 1235554072 · WESTERLY, RI 02891 · Multi-Specialty Clinic/Center · NPI assigned 03/04/2014

$57K

Total Medicaid Paid

1,088

Total Claims

799

Beneficiaries

Codes Billed

2018-01

First Month

2019-11

Last Month

Provider Details

Authorized Official	MARTIN, JONATHAN (OWNER/PHYSICIAN)
NPI Enumeration Date	03/04/2014

Other providers sharing the same authorized official: MARTIN, JONATHAN

Provider	City	State	Total Paid
3MS SERVICES LLC	GASTONIA	NC	$1.40M
OCEAN STATE URGENT CARE CENTER OF BARRINGTON, LLC	BARRINGTON	RI	$96K
OCEAN STATE PRIMARY CARE CENTER OF WESTERLY, LLC	WESTERLY	RI	$64K
MARTIN AND TUCKER INVESTMENTS INC	BRYANT	AR	$51K
OCEAN STATE PRIMARY CARE CENTER OF COVENTRY, LLC	COVENTRY	RI	$35K
GREENWICH BAY MEDICAL ASSOCIATES, LLC	WARWICK	RI	$2K
AVROK BIOSCIENCES, LLC	AZUSA	CA	$400.32

Year	Claims	Total Paid
2018	770	$42K
2019	318	$14K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	726	532	$45K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	234	180	$10K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	14	13	$1K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	79	39	$802.94
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	35	35	$360.46