MATCH-E-BE-NASH-SHE-WISH BAND OF POTTAWATOMI INDIANS
NPI: 1952685588
· SHELBYVILLE, MI 49344
· Community Health Clinic/Center
· NPI assigned 09/30/2011
$411K
Total Medicaid Paid
Provider Details
| Authorized Official | WESAW, KELLY (HEALTH DIRECTOR) |
| NPI Enumeration Date | 09/30/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
29 |
$8K |
| 2021 |
670 |
$58K |
| 2022 |
459 |
$66K |
| 2023 |
724 |
$134K |
| 2024 |
619 |
$145K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total 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 |
1,377 |
1,118 |
$403K |
| 0012A |
|
68 |
68 |
$2K |
| 0011A |
|
62 |
61 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
604 |
513 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
181 |
161 |
$889.81 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
36 |
32 |
$594.72 |
| 0002A |
|
12 |
12 |
$454.20 |
| 91301 |
|
148 |
139 |
$0.00 |
| 91300 |
|
13 |
12 |
$0.00 |