PENN MEDICINE LGHP GERIATRICS

NPI: 1306213020 · WILLOW STREET, PA 17584 · Federally Qualified Health Center (FQHC) · NPI assigned 08/28/2015

$2K

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2018-01

First Month

2018-05

Last Month

Provider Details

Authorized Official	BROWN, KIMBERLY (PROVIDER COORDINATOR)
NPI Enumeration Date	08/28/2015

Other providers sharing the same authorized official: BROWN, KIMBERLY

Provider	City	State	Total Paid
HOCKING VALLEY MEDICAL GROUP, INC.	LOGAN	OH	$1.57M
BRIDGES FOR RECOVERY CENTER, L.LC.	SHREVEPORT	LA	$1.27M
DIVINE PURPOSE ADULT DAYCARE LLC	SAINT LOUIS	MO	$604K
HEALNG HANDS HOME HEALTH SERVICES, LLC	SAINT LOUIS	MO	$582K
FREE YOURSELF COUNSELING SERVICES	MUNCIE	IN	$252K
AEON TECHNOLOGIES, LLC	FROSTBURG	MD	$39K
CARE PROFESSIONALS ADULT CENTER LLC	SAINT LOUIS	MO	$30K
RESILIENT SOUL	DOVER	DE	$17K
VANTAGE THERAPY SERVICES	DURHAM	NC	$13K
TEXAS BEST HEALTH AND BEHAVIORAL CONSULTING, LLC	SUGAR LAND	TX	$0.00

Year	Claims	Total Paid
2018	49	$2K

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	49	42	$2K