Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SOUTHWEST PORTLAND MEDICAL CLINIC INC

NPI: 1245566843 · TACOMA, WA 98418 · Primary Care Clinic/Center · NPI assigned 11/02/2009

$63K
Total Medicaid Paid
2,851
Total Claims
2,528
Beneficiaries
3
Codes Billed
2018-01
First Month
2022-04
Last Month

Provider Details

Authorized OfficialDE LEON, FELINO (PRESIDENT)
NPI Enumeration Date11/02/2009

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 975 $14K
2019 693 $10K
2020 543 $16K
2021 509 $18K
2022 131 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,826 2,503 $63K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 12 12 $100.15
90688 13 13 $50.38