TRI-COUNTY MEMORIAL HOSPITAL, INC.
NPI: 1417201864
· WHITEHALL, WI 54773
· Rural Health Clinic/Center
· NPI assigned 11/07/2012
$200K
Total Medicaid Paid
Provider Details
| Authorized Official | SCHLEICH, ROXANE (CFO, REGIONAL) |
| Parent Organization | TRI-COUNTY MEMORIAL HOSPITAL, INC. |
| NPI Enumeration Date | 11/07/2012 |
Related Entities
Other providers sharing the same authorized official: SCHLEICH, ROXANE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,026 |
$41K |
| 2019 |
976 |
$37K |
| 2020 |
780 |
$26K |
| 2021 |
1,982 |
$56K |
| 2022 |
819 |
$37K |
| 2023 |
65 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,132 |
2,675 |
$110K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
854 |
700 |
$46K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
408 |
396 |
$30K |
| 0012A |
|
142 |
139 |
$5K |
| 0011A |
|
149 |
141 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
171 |
153 |
$2K |
| 0002A |
|
58 |
57 |
$2K |
| 90686 |
|
127 |
124 |
$946.61 |
| 0001A |
|
25 |
25 |
$915.84 |
| 90688 |
|
30 |
29 |
$330.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
44 |
41 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
99 |
97 |
$0.00 |
| 91301 |
|
311 |
289 |
$0.00 |
| 91300 |
|
98 |
90 |
$0.00 |