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NPI 1518404854 · Glendale, WI · Addiction Medicine (Internal Medicine) Physician
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Cleanslate Medical Group Of Wisconsin, Sc is a addiction medicine (internal medicine) physician provider located in Glendale, Wisconsin. This profile covers 0 Medicare and 25 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Cleanslate Medical Group Of Wisconsin, Sc |
| Address | 377 W River Woods Pkwy Ste 201 |
| City | Glendale |
| State | WI |
| ZIP | 53212 |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| NPI Enumerated | January 25, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $17.1M |
| Medicare | $0 |
This provider is effectively single‑payer: there is no Medicare billing on file while Medicaid revenue totals $17.1M, indicating the organization’s fiscal footprint is concentrated entirely in the Medicaid program rather than split across Medicare and Medicaid. Analysts should treat Medicaid reimbursement and policy changes as the primary revenue drivers for this entity's financial performance.
Revenue concentration is extremely high: the precomputed top 3 codes (99214, 80307, 99213) account for 92.9% of the provider’s total Medicaid revenue. Specifically, 99214 accounts for $9.6M (56.2%), 80307 accounts for $4M (23.4%), and 99213 accounts for $2.3M (13.4%), so a small set of services generates the vast majority of cash flow.
The code mix and volumes point to an addiction/medication‑management outpatient model: 99214 (240.7K claims, $40 avg paid/claim, $9.6M) and 99213 (88K claims, $26 avg paid/claim, $2.3M) are high‑volume evaluation-and-management visits, while 80307 (133.6K claims, $30 avg paid/claim, $4M) and G0480 (31.3K claims, $32 avg paid/claim, $1M) reflect extensive point-of-care and definitive drug testing. Together these patterns are consistent with frequent follow-up visits and intensive toxicology monitoring typical of medication‑assisted treatment and outpatient addiction services.
On statewide competitive standing this provider is a dominant outlier for key codes: 80307 ranks #1 of 190 providers in‑state (100th percentile; extreme outlier) and 99214 ranks #3 of 1628 (100th percentile; extreme outlier), while 99213 ranks #21 of 1755 (99th percentile; extreme outlier). These rank/percentile positions indicate the provider operates at volumes far above typical in‑state peers for both high‑level E/M visits and drug testing.
Laboratory testing represents a material and distinctive revenue channel beyond basic E/M visits: G0480 generates $1M (5.9% of Medicaid revenue) with 31.3K claims and ranks #2 of 115 providers in‑state (99th percentile; extreme outlier), while 80307’s $4M contribution underscores very high utilization of instrumented presumptive drug screens. The combination of high volumes in both presumptive and definitive drug testing suggests an in‑house or closely integrated lab workflow that supports the clinical care model.
Behavioral health and ancillary services are present but small relative to core volumes: psychotherapy codes (90832, 90834, 90837) and other behavioral‑health CPTs together account for only modest revenue (for example 90832 is $59.3K, 0.3% of Medicaid revenue) and rank at typical to below‑top state percentiles. This indicates that while behavioral health services are offered, they are not the primary revenue driver compared with E/M visits and drug testing.
The provider has an established enrollment history, with the NPI enumerated 2017-01-25 (~9 years ago), which aligns with the accumulation of large Medicaid volumes reported here. Tenure of roughly nine years supports a sustained operational presence and scale in the Wisconsin Medicaid market.
From a payer and network risk perspective, the business is highly dependent on a narrow set of procedure codes and very large visit and testing volumes; this concentration (92.9% of Medicaid revenue from the top three codes) could create revenue sensitivity to policy, coverage, or rate changes targeting E/M visit reimbursement or drug‑testing rules. Contracting and utilization‑management reviews should prioritize these codes and the operational processes that generate their high claim counts.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 240,700 | $40 | $9.6M |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 133,610 | $30 | $4M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 88,020 | $30 | $2.3M |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 31,340 | $30 | $1M |
| 90832 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 1,910 | $30 | $59.3K |
| 81025 | The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout. | 7,500 | $10 | $37.5K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 2,020 | $20 | $30.2K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 610 | $40 | $23.7K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 380 | $50 | $19.4K |
| Q3014 | Telehealth originating site facility fee | 2,700 | $10 | $18.9K |
Showing 1–10 of 25
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
25 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0003 | Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs | 49 | 100 | 150 | $60 | $657.7K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 1 | 190 | 620 | $40 | $226.6K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 3 | 1,630 | 270 | $40 | $205.3K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 21 | 1,760 | 250 | $40 | $173.2K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 896 | 900 | 410 | $70 | $130.4K |
| H0038 | Self‑help/peer services, per 15 minutes | 11 | 10 | 260 | $70 | $124K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 2 | 120 | 770 | $40 | $117.9K |
| 90834 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 584 | 790 | 400 | $40 | $109.6K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 96 | 690 | 160 | $60 | $90.4K |
| 90853 | Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of… | 101 | 110 | 270 | $50 | $87.4K |
Showing 1–10 of 25
Other providers in the same ZIP code as Cleanslate Medical Group Of Wisconsin, Sc, ranked by combined Medicare and Medicaid revenue.
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