Medicaid Provider Spending

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

COUNTRYSIDE MEDICAL CLINIC, LLC

NPI: 1396103685 · RED OAK, IA 51566 · Primary Care Clinic/Center · NPI assigned 02/02/2016

$191K
Total Medicaid Paid
5,433
Total Claims
3,963
Beneficiaries
12
Codes Billed
2018-01
First Month
2024-02
Last Month

Provider Details

Authorized OfficialRINES, KIMBERLY (NURSE PRACTITIONER)
NPI Enumeration Date02/02/2016

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 222 $10K
2019 379 $13K
2020 821 $25K
2021 996 $31K
2022 2,034 $74K
2023 920 $35K
2024 61 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 2,863 2,041 $128K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,744 1,291 $47K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 317 209 $8K
90838 47 27 $3K
87428 14 12 $2K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 53 41 $1K
90688 16 12 $403.80
36415 Collection of venous blood by venipuncture 165 157 $363.80
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 140 107 $347.14
90756 20 19 $251.81
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 19 17 $233.07
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 35 30 $140.64