Medicaid Provider Spending

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

SAN JOSE HEALTH CLINIC, LLC

NPI: 1770753162 · SAN LUIS, AZ 85349 · Family Medicine Physician · NPI assigned 03/03/2008

$91K
Total Medicaid Paid
6,299
Total Claims
4,437
Beneficiaries
16
Codes Billed
2018-01
First Month
2018-08
Last Month

Provider Details

Authorized OfficialPISCOYA, JOSE (PRESIDENT)
NPI Enumeration Date03/03/2008

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 6,299 $91K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,442 1,024 $70K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 295 224 $7K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 606 516 $5K
99215 Prolong outpt/office vis 43 40 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 29 29 $2K
36415 Collection of venous blood by venipuncture 736 609 $1K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 44 41 $835.83
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 13 12 $696.96
93922 56 53 $634.02
93000 60 56 $482.98
1170F 50 42 $0.00
1126F 112 93 $0.00
1125F 122 93 $0.00
3044F 34 34 $0.00
1160F 1,338 786 $0.00
1159F 1,319 785 $0.00