Medicaid Provider Spending

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

FAMILY MEDICINE OF MCLEANSBORO LLC

NPI: 1801920889 · MCLEANSBORO, IL 62859 · Family Nurse Practitioner · NPI assigned 03/14/2007

$172K
Total Medicaid Paid
4,219
Total Claims
3,173
Beneficiaries
4
Codes Billed
2018-01
First Month
2019-01
Last Month

Provider Details

Authorized OfficialDAVENPORT, MICHAEL (MANAGER)
NPI Enumeration Date03/14/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 3,843 $155K
2019 376 $16K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 2,404 1,801 $167K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,766 1,342 $5K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 35 18 $211.87
81002 14 12 $0.08