Medicaid Provider Spending

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

CHILDREN'S COMMUNITY CARE

NPI: 1023294097 · JEFFERSON HILLS, PA 15025 · Pediatrics Physician · NPI assigned 01/21/2008

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official MARTINEZ, LORI controls 20+ related entities in our dataset. Read more

$151K
Total Medicaid Paid
3,207
Total Claims
2,973
Beneficiaries
23
Codes Billed
2022-09
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMARTINEZ, LORI (EXECUTIVE ADMINISTRATOR III)
NPI Enumeration Date01/21/2008

Related Entities

Other providers sharing the same authorized official: MARTINEZ, LORI

ProviderCityStateTotal Paid
CHILDREN'S COMMUNITY CARE WEXFORD PA $5.17M
CHILDREN'S COMMUNITY CARE SEWICKLEY PA $3.28M
CHILDREN'S COMMUNITY CARE UNIONTOWN PA $1.02M
CHILDREN'S COMMUNITY CARE PITTSBURGH PA $898K
CHILDEN'S COMMUNITY CARE NEW CASTLE PA $646K
CHILDREN'S COMMUNITY CARE MONONGAHELA PA $628K
CHILDREN'S COMMUNITY CARE ERIE PA $580K
CHILDEN'S COMMUNITY CARE PITTSBURGH PA $535K
CHILDEN'S COMMUNITY CARE HUMMELSTOWN PA $522K
CHILDREN'S COMMUNITY CARE YORK PA $500K
CHILDREN'S COMMUNITY CARE HUNTINGDON PA $470K
CHILDREN'S COMMUNITY CARE WEXFORD PA $467K
CHILDEN'S COMMUNITY CARE CAMP HILL PA $438K
CHILDREN'S COMMUNITY CARE PITTSBURGH PA $414K
CHILDREN'S COMMUNITY CARE NEW CASTLE PA $394K
CHILDEN'S COMMUNITY CARE HERMITAGE PA $276K
CHILDREN'S COMMUNITY CARE NORTH HUNTINGDON PA $252K
CHILDREN'S COMMUNITY CARE NATRONA HEIGHTS PA $207K
CHILDREN'S COMMUNITY CARE WHITE OAK PA $181K
CHILDEN'S COMMUNITY CARE GROVE CITY PA $177K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 459 $26K
2023 1,080 $58K
2024 1,668 $67K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,177 1,096 $108K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 379 352 $24K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 84 84 $9K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 57 55 $3K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 135 66 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 18 18 $2K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 92 82 $1K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 230 219 $0.00
96160 60 60 $0.00
G9920 Screening performed and negative 215 209 $0.00
90670 37 37 $0.00
90648 57 49 $0.00
99177 28 28 $0.00
90661 23 23 $0.00
90651 39 38 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 87 79 $0.00
92551 151 151 $0.00
90686 159 157 $0.00
90656 53 53 $0.00
96127 60 60 $0.00
90619 17 16 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 29 29 $0.00
90677 20 12 $0.00