Spectrum Health Medical Clinic, LLC

Spectrum Health Medical Clinic, LLC was paid $1.03M by Medicaid between Jan 2018 and Jan 2022, across 7 billing codes. Its largest line is 80307, Drug test(s), presumptive, any number of drug classes; immunoassay — 58% of everything it billed.

33Billing provider infoSPECTRUM HEALTH MEDICAL CLINIC, LLC
GERMANTOWN, WI 53022

33aNPI1477981942assigned 10/21/2013

33bProvider typeGeneral Practice Physician

28Total paid$1.03M

24GClaims28,244

24DCodes billed7

24AFirst – last monthJan 2018 – Jan 2022

Compared with peers

Next to other General Practice Physician providers in Wisconsin

Rank by total paid#6 of 20

Median peer was paid$18K

This provider vs. median58×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	10,855	$330K
2019	7,820	$265K
2020	4,807	$221K
2021	4,527	$197K
2022	235	$11K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	58%	10,628	6,862	$591K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	34%	8,844	6,999	$345K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	7.8%	2,948	1,546	$80K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	<1%	118	108	$8K
99401		<1%	55	45	$1K
3008F		<1%	5,359	3,699	$140.00
99072		<1%	292	221	$40.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialLOCKE, JOSEPH (PRESIDENT/OWNER)