COUNTRY VILLA SOUTH BAY, LLC
NPI: 1649264912
· LONG BEACH, CA 90804
· 314000000X
$319K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,047 |
$30K |
| 2019 |
723 |
$18K |
| 2020 |
4,743 |
$150K |
| 2021 |
859 |
$29K |
| 2022 |
1,394 |
$87K |
| 2023 |
78 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97530 |
|
3,460 |
247 |
$129K |
| 97110 |
|
3,291 |
306 |
$118K |
| 97112 |
|
1,409 |
207 |
$44K |
| 97535 |
|
444 |
61 |
$16K |
| 97763 |
|
109 |
13 |
$7K |
| 97162 |
|
27 |
24 |
$2K |
| 97140 |
|
73 |
12 |
$1K |
| 97166 |
|
14 |
14 |
$1K |
| Q3014 |
Telehealth facility fee |
17 |
17 |
$271.64 |