CLEANSLATE MEDICAL GROUP OF WISCONSIN, SC
NPI: 1518404854
· GLENDALE, WI 53212
· 207RA0401X
$17.13M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
20,318 |
$496K |
| 2019 |
75,543 |
$1.51M |
| 2020 |
108,044 |
$2.57M |
| 2021 |
90,997 |
$3.34M |
| 2022 |
86,059 |
$3.11M |
| 2023 |
69,630 |
$2.63M |
| 2024 |
64,048 |
$3.47M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
240,698 |
126,923 |
$9.61M |
| 80307 |
|
133,607 |
73,197 |
$4.05M |
| 99213 |
|
88,016 |
55,840 |
$2.27M |
| G0480 |
Drug test def 1-7 classes |
31,344 |
23,798 |
$988K |
| 90832 |
|
1,913 |
1,062 |
$59K |
| 81025 |
|
7,495 |
6,107 |
$40K |
| 99212 |
|
2,015 |
1,180 |
$31K |
| 99203 |
|
608 |
543 |
$23K |
| 99204 |
|
381 |
327 |
$19K |
| Q3014 |
Telehealth facility fee |
2,695 |
1,656 |
$18K |
| 87389 |
|
543 |
437 |
$6K |
| 86803 |
|
548 |
444 |
$4K |
| 90791 |
|
106 |
94 |
$4K |
| 99202 |
|
126 |
103 |
$3K |
| 87340 |
|
585 |
474 |
$3K |
| 90834 |
|
73 |
31 |
$2K |
| 96127 |
|
404 |
339 |
$1K |
| 99484 |
|
683 |
513 |
$709.74 |
| 80076 |
|
69 |
63 |
$653.32 |
| 90837 |
|
14 |
12 |
$564.15 |
| 90853 |
|
30 |
25 |
$281.40 |
| 96372 |
|
63 |
50 |
$188.67 |
| 99406 |
|
2,321 |
1,104 |
$32.69 |
| H0003 |
Alcohol and/or drug screenin |
178 |
127 |
$1.34 |
| H0038 |
Self-help/peer svc per 15min |
124 |
116 |
$0.00 |