Medicaid Provider Spending

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

PROMUS DIAGNOSTICS, LLC

NPI: 1033680681 · SOUTHLAKE, TX 76092 · Clinical Medical Laboratory · NPI assigned 12/07/2018

$277K
Total Medicaid Paid
23,545
Total Claims
13,249
Beneficiaries
23
Codes Billed
2020-06
First Month
2023-06
Last Month

Provider Details

Authorized OfficialSANSONE, VICTOR (OWNER)
NPI Enumeration Date12/07/2018

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 3,889 $3K
2021 7,771 $212K
2022 8,538 $61K
2023 3,347 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 5,055 1,932 $234K
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 4,272 1,680 $34K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 1,596 1,061 $6K
87150 794 597 $656.51
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 1,189 499 $564.24
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 803 598 $541.46
87481 1,547 1,059 $300.77
87500 1,578 1,053 $173.99
87641 1,538 1,049 $142.88
87653 1,557 1,061 $142.88
87640 1,564 1,062 $111.77
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 560 428 $90.23
87556 381 269 $66.52
87511 249 178 $31.11
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 205 186 $28.01
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 206 188 $28.01
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 207 186 $28.01
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 106 74 $0.00
P9604 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge 16 12 $0.00
86409 12 12 $0.00
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 not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 16 12 $0.00
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 77 36 $0.00
P9603 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled 17 17 $0.00