CLEANSLATE MEDICAL GROUP OF VIRGINIA, LLC
NPI: 1629549779
· MECHANICSVILLE, VA 23116
· 207R00000X
$4.28M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
1,745 |
$55K |
| 2020 |
13,291 |
$618K |
| 2021 |
16,477 |
$1.05M |
| 2022 |
13,325 |
$991K |
| 2023 |
13,068 |
$1.03M |
| 2024 |
6,191 |
$538K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
28,518 |
15,635 |
$2.10M |
| 99213 |
|
16,157 |
10,973 |
$853K |
| G9012 |
Other specified case mgmt |
2,761 |
2,678 |
$568K |
| 80307 |
|
9,067 |
4,784 |
$466K |
| G0480 |
Drug test def 1-7 classes |
2,932 |
2,089 |
$152K |
| H0004 |
Alcohol and/or drug services |
572 |
412 |
$27K |
| T1016 |
Case management |
461 |
383 |
$27K |
| 99204 |
|
313 |
294 |
$27K |
| 90791 |
|
78 |
77 |
$11K |
| Q3014 |
Telehealth facility fee |
411 |
287 |
$8K |
| 90832 |
|
178 |
159 |
$8K |
| 99203 |
|
97 |
81 |
$6K |
| 81025 |
|
907 |
818 |
$5K |
| H0006 |
Alcohol and/or drug services |
147 |
119 |
$5K |
| 99409 |
|
74 |
60 |
$3K |
| 96372 |
|
192 |
166 |
$2K |
| 90837 |
|
16 |
12 |
$1K |
| H0038 |
Self-help/peer svc per 15min |
316 |
226 |
$1K |
| 99212 |
|
41 |
39 |
$1K |
| 87389 |
|
87 |
67 |
$791.37 |
| 86803 |
|
72 |
65 |
$750.60 |
| H2027 |
Psychoed svc, per 15 min |
53 |
25 |
$618.21 |
| 99484 |
|
58 |
36 |
$414.61 |
| 99406 |
|
43 |
35 |
$372.70 |
| 87340 |
|
85 |
66 |
$355.29 |
| S9475 |
Ambulatory setting substance |
461 |
278 |
$142.80 |