EAST SIDE PRIMARY CARE PROVIDENCE LLC

NPI: 1558816330 · PROVIDENCE, RI 02904 · Internal Medicine Physician · NPI assigned 08/22/2016

$20K

Total Medicaid Paid

306

Total Claims

255

Beneficiaries

Codes Billed

2018-01

First Month

2019-01

Last Month

Provider Details

Authorized Official	D'ALESSANDRO, FRANK (OWNER)
NPI Enumeration Date	08/22/2016

Other providers sharing the same authorized official: D'ALESSANDRO, FRANK

Provider	City	State	Total Paid
LINCOLN URGENT CARE CENTER, INC.	LINCOLN	RI	$969K
OCEAN STATE URGENT CARE CENTER OF WOONSOCKET	WOONSOCKET	RI	$918K
OCEAN STATE URGENT CARE CENTER OF CUMBERLAND, LLC	CUMBERLAND	RI	$449K
OCEAN STATE URGENT CARE CENTER OF SMITHFIELD LLC	SMITHFIELD	RI	$402K
OCEAN STATE URGENT CARE AT ST JOSEPH HEALTH CENTER LLC	PROVIDENCE	RI	$18K

Year	Claims	Total Paid
2018	274	$19K
2019	32	$2K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	229	182	$15K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	46	45	$4K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	16	13	$713.30
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	15	15	$0.00