Medicaid Provider Spending

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

JACK COUNTY HOSPITAL DISTRICT

NPI: 1790777696 · JACKSBORO, TX 76458 · Family Medicine Physician · NPI assigned 08/17/2005

$578K
Total Medicaid Paid
8,820
Total Claims
7,810
Beneficiaries
20
Codes Billed
2020-11
First Month
2024-10
Last Month

Provider Details

Authorized OfficialLEE, KIM (COO)
NPI Enumeration Date08/17/2005

Related Entities

Other providers sharing the same authorized official: LEE, KIM

ProviderCityStateTotal Paid
JACK COUNTY HOSPITAL DISTRICT JACKSBORO TX $1.44M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 13 $5K
2021 1,879 $263K
2022 2,119 $178K
2023 2,418 $95K
2024 2,391 $37K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 889 823 $472K
99283 Emergency department visit for the evaluation and management, moderate severity 164 147 $43K
99284 Emergency department visit for the evaluation and management, high severity 117 111 $32K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1,647 1,452 $8K
80053 Comprehensive metabolic panel 1,249 1,101 $6K
84443 Thyroid stimulating hormone (TSH) 622 603 $6K
87631 37 37 $5K
36415 Collection of venous blood by venipuncture 2,552 2,115 $2K
99282 Emergency department visit for the evaluation and management, low to moderate severity 12 12 $1K
83036 Hemoglobin; glycosylated (A1C) 278 275 $777.63
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 158 152 $450.81
87086 Culture, bacterial; quantitative colony count, urine 153 141 $443.47
82607 188 179 $383.89
81015 263 232 $338.83
80061 Lipid panel 201 198 $300.46
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 12 12 $286.19
81001 204 184 $79.58
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 13 12 $54.73
84439 13 12 $19.56
K1034 Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count 48 12 $0.00