Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

IVYDALE WELLNESS CENTER LLC

NPI: 1659919066 · WINDER, GA 30680 · Family Nurse Practitioner · NPI assigned 12/16/2019

$12K
Total Medicaid Paid
144
Total Claims
127
Beneficiaries
2
Codes Billed
2024-03
First Month
2024-10
Last Month

Provider Details

Authorized OfficialAGOMESSOU, ABLAVI (OWNER)
NPI Enumeration Date12/16/2019

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 144 $12K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 132 115 $10K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 12 12 $2K