THIRD STREET COMMUNITY CLINIC, INC
NPI: 1336411156
· MANSFIELD, OH 44907
· Federally Qualified Health Center (FQHC)
· NPI assigned 02/09/2012
$109K
Total Medicaid Paid
Provider Details
| Authorized Official | POLLICK, JARED (CEO) |
| NPI Enumeration Date | 02/09/2012 |
Related Entities
Other providers sharing the same authorized official: POLLICK, JARED
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,659 |
$109K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,223 |
781 |
$72K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,987 |
1,195 |
$34K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
324 |
274 |
$2K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
40 |
30 |
$1K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
85 |
78 |
$0.11 |