Physician
Evergreen Clinic LLC
Evergreen Clinic LLC was paid $4K by Medicaid between Jul 2022 and Jul 2023, across 1 billing code. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 100% of everything it billed.
33Billing provider infoEVERGREEN CLINIC LLC
WEST JORDAN, UT 84084
WEST JORDAN, UT 84084
33aNPI1689210551assigned 11/25/2019
33bProvider typeFamily Medicine Physician
28Total paid$4K
24GClaims66
24DCodes billed1
24AFirst – last monthJul 2022 – Jul 2023
Compared with peers
Next to other Family Medicine Physician providers in Utah
Rank by total paid#285 of 426
Median peer was paid$12K
This provider vs. median0.3×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2022 | 21 | $2K | |
| 2023 | 45 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 100% | 66 | 53 | $4K |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGONZALEZ, IGNACIO (ADMINISTRATOR)