CLEANSLATE MEDICAL GROUP OF KENTUCKY PLLC
NPI: 1538600630
· LOUISVILLE, KY 40258
· 207RA0401X
$10.48M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
292 |
$13K |
| 2019 |
17,512 |
$657K |
| 2020 |
40,938 |
$1.45M |
| 2021 |
43,684 |
$1.72M |
| 2022 |
50,979 |
$2.28M |
| 2023 |
42,867 |
$2.46M |
| 2024 |
33,956 |
$1.91M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
133,603 |
77,130 |
$6.48M |
| 99213 |
|
42,275 |
28,311 |
$1.48M |
| 80307 |
|
27,861 |
16,713 |
$1.31M |
| T2023 |
Targeted case mgmt per month |
1,361 |
1,280 |
$415K |
| G0480 |
Drug test def 1-7 classes |
3,872 |
2,917 |
$305K |
| 90832 |
|
7,795 |
5,809 |
$288K |
| 99204 |
|
613 |
522 |
$46K |
| 90791 |
|
419 |
339 |
$32K |
| 81025 |
|
5,113 |
4,561 |
$28K |
| 99406 |
|
3,302 |
1,898 |
$20K |
| 99203 |
|
386 |
300 |
$19K |
| 99202 |
|
502 |
465 |
$17K |
| 90834 |
|
202 |
166 |
$11K |
| Q3014 |
Telehealth facility fee |
1,799 |
1,324 |
$7K |
| 99212 |
|
248 |
185 |
$5K |
| 87389 |
|
193 |
180 |
$4K |
| 86803 |
|
184 |
170 |
$2K |
| 87340 |
|
183 |
169 |
$2K |
| 99215 |
Prolong outpt/office vis |
16 |
16 |
$1K |
| 90853 |
|
61 |
57 |
$890.45 |
| 86704 |
|
42 |
40 |
$392.35 |
| 86706 |
|
46 |
44 |
$383.85 |
| 80076 |
|
40 |
35 |
$233.17 |
| 96127 |
|
84 |
82 |
$211.52 |
| G2012 |
Brief check in by md/qhp |
28 |
25 |
$151.51 |