CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

$1.04M

Total Medicaid Paid

13,199

Total Claims

11,010

Beneficiaries

20

Codes Billed

2018-01

First Month

2019-09

Last Month

Authorized Official	JAHANGIR, NUSRATH (COO)
NPI Enumeration Date	03/30/2016

Provider	City	State	Total Paid
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION	LOS ANGELES	CA	$1.04M

Year	Claims	Total Paid
2018	12,942	$1.03M
2019	257	$5K

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	7,221	5,902	$995K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	2,050	1,875	$18K
59425		723	477	$11K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	110	90	$6K
99215	Prolong outpt/office vis	73	73	$2K
81002		613	425	$1K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	1,034	959	$737.02
81025		332	308	$570.65
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	116	115	$418.72
J3490	Unclassified drugs	14	14	$244.62
99000		114	111	$75.75
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	27	27	$34.34
92551		41	40	$33.98
99173		127	123	$28.29
85018		158	152	$8.83
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	14	14	$4.42
90698		13	13	$0.00
0502F		323	204	$0.00
82947		69	61	$0.00
90670		27	27	$0.00

Medicaid Provider Spending