Medicaid Provider Spending

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

CLEANSLATE MEDICAL GROUP OF WISCONSIN, SC

NPI: 1518404854 · GLENDALE, WI 53212 · Addiction Medicine (Internal Medicine) Physician · NPI assigned 01/25/2017

$17.13M
Total Medicaid Paid
514,639
Total Claims
294,565
Beneficiaries
25
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSMOLAREK, MATTHEW (CFO)
NPI Enumeration Date01/25/2017

Related Entities

Other providers sharing the same authorized official: SMOLAREK, MATTHEW

ProviderCityStateTotal Paid
CLEANSLATE MEDICAL GROUP OF INDIANA LLC ALEXANDRIA IN $79.21M
TOTAL WELLNESS CENTERS, LLC HOLYOKE MA $77.17M
TOTAL WELLNESS CENTERS, LLC WEST SPRINGFIELD MA $38.42M
CLEANSLATE MEDICAL GROUP OF PENNSYLVANIA LLC WILKES BARRE PA $18.61M
CLEANSLATE MEDICAL GROUP OF KENTUCKY PLLC LOUISVILLE KY $10.48M
CLEANSLATE MEDICAL GROUP OF OHIO LLC MORAINE OH $9.53M
CLEANSLATE MEDICAL GROUP OF VIRGINIA, LLC MECHANICSVILLE VA $4.28M
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC GILBERT AZ $955K
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC PHOENIX AZ $248K
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC PHOENIX AZ $101K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 240,698 126,923 $9.61M
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 133,607 73,197 $4.05M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 88,016 55,840 $2.27M
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 31,344 23,798 $988K
90832 Psychotherapy, 30 minutes with patient 1,913 1,062 $59K
81025 7,495 6,107 $40K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,015 1,180 $31K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 608 543 $23K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 381 327 $19K
Q3014 Telehealth originating site facility fee 2,695 1,656 $18K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 543 437 $6K
86803 548 444 $4K
90791 Psychiatric diagnostic evaluation 106 94 $4K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 126 103 $3K
87340 585 474 $3K
90834 Psychotherapy, 45 minutes with patient 73 31 $2K
96127 404 339 $1K
99484 683 513 $709.74
80076 69 63 $653.32
90837 Psychotherapy, 53 minutes with patient 14 12 $564.15
90853 Group psychotherapy (other than of a multiple-family group) 30 25 $281.40
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 63 50 $188.67
99406 2,321 1,104 $32.69
H0003 Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs 178 127 $1.34
H0038 Self-help/peer services, per 15 minutes 124 116 $0.00