WESTSIDE FAMILY MEDICAL CLINIC PLLC
NPI: 1811234636
· SUMNER, MS 38957
· Primary Care Clinic/Center
· NPI assigned 01/14/2013
$166K
Total Medicaid Paid
Provider Details
| Authorized Official | TUCKER, ROBERT (CEO) |
| NPI Enumeration Date | 01/14/2013 |
Related Entities
Other providers sharing the same authorized official: TUCKER, ROBERT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,052 |
$87K |
| 2019 |
1,576 |
$68K |
| 2020 |
310 |
$12K |
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 |
2,666 |
2,137 |
$107K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
877 |
771 |
$52K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
86 |
75 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
120 |
113 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
54 |
37 |
$345.47 |
| 90756 |
|
20 |
20 |
$340.43 |
| 99407 |
|
42 |
27 |
$184.95 |
| 82947 |
|
44 |
39 |
$76.48 |
| 90656 |
|
29 |
22 |
$16.90 |