Medicaid Provider Spending

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

EVERGREEN CLINIC LLC

NPI: 1689210551 · WEST JORDAN, UT 84084 · Family Medicine Physician · NPI assigned 11/25/2019

$4K
Total Medicaid Paid
66
Total Claims
53
Beneficiaries
1
Codes Billed
2022-07
First Month
2023-07
Last Month

Provider Details

Authorized OfficialGONZALEZ, IGNACIO (ADMINISTRATOR)
NPI Enumeration Date11/25/2019

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 21 $2K
2023 45 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 66 53 $4K