CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
NPI: 1245865096
· PHOENIX, AZ 85037
· Multi-Specialty Clinic/Center
· NPI assigned 03/11/2020
$248K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: SMOLAREK, MATTHEW
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
1,363 |
$35K |
| 2022 |
2,122 |
$78K |
| 2023 |
1,543 |
$58K |
| 2024 |
1,537 |
$77K |
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 |
2,299 |
1,600 |
$125K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,122 |
2,719 |
$120K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
13 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
25 |
17 |
$1K |
| 81025 |
|
105 |
101 |
$417.82 |