Medicaid Provider Spending

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

LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS

NPI: 1871272583 · PETOSKEY, MI 49770 · Federally Qualified Health Center (FQHC) · NPI assigned 07/12/2023

$353K
Total Medicaid Paid
6,926
Total Claims
5,766
Beneficiaries
25
Codes Billed
2023-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialDUBOIS, CHRISTINA (ASSISTANT HEALTH DIRECTOR)
NPI Enumeration Date07/12/2023

Related Entities

Other providers sharing the same authorized official: DUBOIS, CHRISTINA

ProviderCityStateTotal Paid
LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS PETOSKEY MI $8.80M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 3,119 $170K
2024 3,807 $183K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 2,341 1,830 $155K
G0470 Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit 388 189 $51K
G0466 Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 558 556 $50K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 804 726 $33K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 932 822 $27K
99215 Prolong outpt/office vis 174 156 $10K
G0468 Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv 139 138 $10K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 84 83 $3K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 197 177 $3K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 57 57 $2K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 297 141 $2K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 228 202 $1K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 62 62 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 111 107 $951.67
36415 Collection of venous blood by venipuncture 254 242 $940.45
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 42 40 $697.13
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 13 13 $544.98
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 52 50 $467.48
80305 34 27 $198.17
96127 47 44 $130.14
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 54 52 $102.39
81025 18 15 $57.04
87807 14 12 $32.55
81002 14 13 $17.28
81003 12 12 $11.22