RIVERSIDE MEDICAL CLINIC
NPI: 1811206923
· LAKE CITY, AR 72347
· Family Medicine Physician
· NPI assigned 10/07/2010
$126K
Total Medicaid Paid
Provider Details
| Authorized Official | WAGNER, TOMMY (OWNER) |
| NPI Enumeration Date | 10/07/2010 |
Related Entities
Other providers sharing the same authorized official: WAGNER, TOMMY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
857 |
$32K |
| 2019 |
813 |
$28K |
| 2020 |
602 |
$20K |
| 2021 |
444 |
$17K |
| 2022 |
415 |
$13K |
| 2023 |
439 |
$14K |
| 2024 |
120 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,159 |
1,864 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,324 |
1,259 |
$61K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
35 |
29 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
64 |
60 |
$722.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
65 |
44 |
$474.47 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
15 |
$133.48 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$77.56 |
| 99406 |
|
13 |
12 |
$0.00 |