CC DOCTORS CENTER PORTLAND, PLLC

NPI: 1821544396 · PORTLAND, TX 78374 · Emergency Medicine Physician · NPI assigned 08/25/2016

$12K

Total Medicaid Paid

614

Total Claims

576

Beneficiaries

Codes Billed

2023-04

First Month

2024-11

Last Month

Provider Details

Authorized Official	ROSE, JAMES (PRESIDENT CEO)
NPI Enumeration Date	08/25/2016

Other providers sharing the same authorized official: ROSE, JAMES

Provider	City	State	Total Paid
SERV CENTERS OF NEW JERSEY, INC	CLIFTON	NJ	$8.59M
JIM ROSE, LCPC, LLC	FREDERICK	MD	$207K
PALMETTO PODIATRY GROUP OF ANDERSON, PA	ANDERSON	SC	$17K

Year	Claims	Total Paid
2023	371	$2K
2024	243	$10K

Code	Description	Claims	Beneficiaries	Total Paid
99215	Prolong outpt/office vis	337	311	$9K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	57	52	$2K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	91	88	$893.93
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	68	65	$87.30
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	36	35	$74.66
J1100	Injection, dexamethasone sodium phosphate, 1 mg	25	25	$0.00