Medicaid Provider Spending

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

NORTHWEST PEDIATRIC SPECIALISTS, LLC

NPI: 1033709100 · TOLEDO, OH 43608 · Pediatrics Physician · NPI assigned 01/22/2021

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

Authorized official MILLER, RICHARD controls 20+ related entities in our dataset. Read more

$4.44M
Total Medicaid Paid
180,187
Total Claims
133,256
Beneficiaries
89
Codes Billed
2022-03
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMILLER, RICHARD (AUTHORIZED OFFICIAL)
Parent OrganizationNATIONWIDE CHILDREN'S HOSPITAL
NPI Enumeration Date01/22/2021

Related Entities

Other providers sharing the same authorized official: MILLER, RICHARD

ProviderCityStateTotal Paid
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $42.17M
NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC TOLEDO OH $12.53M
NASSAU HEALTH CARE CORPORATION UNIONDALE NY $11.59M
OHIO PEDIATRIC CARE ALLIANCE PHYSICIANS, LLC SPRINGFIELD OH $5.50M
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $5.34M
SUNY HEALTH SCIENCE CENTER AT BKLYN BROOKLYN NY $2.99M
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $1.99M
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $1.72M
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $1.29M
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $605K
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $554K
NORTHWEST CHILDREN'S COMMUNITY PRACTICES II, LLC TOLEDO OH $542K
SOUTHWEST MS NEPHROLOGY, PLLC BROOKHAVEN MS $471K
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $318K
PULMONARY & CRITICAL CARE ASSOCIATES NEWARK NJ $314K
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $302K
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $151K
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $146K
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $102K
NASSAU HEALTH CARE CORPORATION EAST MEADOW NY $97K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 64,206 $1.40M
2023 65,880 $1.70M
2024 50,101 $1.34M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 36,216 29,678 $1.19M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 24,117 20,077 $1.10M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 9,488 7,787 $417K
90460 Immunization administration through 18 years of age via any route, first or only component 26,365 10,146 $369K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 6,426 5,430 $255K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,643 3,722 $182K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,070 1,719 $113K
99244 Office or other outpatient consultation, moderate to high complexity 1,377 1,141 $80K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1,781 1,367 $78K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 945 801 $59K
95720 345 145 $49K
99479 Subsequent intensive care, per day, very low birth weight infant 527 115 $47K
92587 2,789 2,256 $47K
99243 857 791 $34K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 4,124 3,117 $31K
99177 5,092 3,805 $30K
99480 Subsequent intensive care, per day, low birth weight infant 334 112 $28K
90791 Psychiatric diagnostic evaluation 346 310 $27K
96110 Developmental screening, with scoring and documentation, per standardized instrument 6,359 4,775 $24K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 271 259 $22K
95816 745 579 $21K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 524 453 $16K
94010 1,615 1,216 $14K
93304 406 310 $13K
93320 719 590 $13K
99239 Hospital discharge day management, more than 30 minutes 300 258 $13K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 775 696 $11K
99223 Prolong inpt eval add15 m 139 114 $11K
99215 Prolong outpt/office vis 177 159 $10K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 398 294 $9K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger 30 12 $9K
90670 1,227 1,030 $8K
95812 94 81 $8K
99232 Subsequent hospital care, per day, moderate complexity 260 140 $7K
93325 1,335 1,051 $7K
92567 836 637 $7K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 50 42 $6K
90686 1,945 1,552 $6K
99222 Initial hospital care, per day, moderate complexity 94 81 $5K
99188 231 200 $5K
90698 810 692 $5K
99233 Prolong inpt eval add15 m 96 52 $4K
90832 Psychotherapy, 30 minutes with patient 80 75 $3K
92579 235 193 $3K
93321 366 279 $3K
92652 42 27 $3K
99238 Hospital discharge day management, 30 minutes or less 81 72 $3K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 228 184 $3K
85018 1,398 1,129 $2K
92552 164 126 $2K
99205 Prolong outpt/office vis 27 25 $2K
99245 19 13 $2K
99382 39 36 $2K
29065 36 32 $2K
92551 356 259 $2K
99417 Prolong home eval add 15m 137 25 $1K
90633 173 143 $1K
99173 748 584 $1K
90671 125 101 $1K
90680 375 328 $970.00
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 12 12 $898.13
36415 Collection of venous blood by venipuncture 358 306 $880.07
90710 47 43 $807.75
31575 29 24 $802.36
69210 50 37 $772.24
99383 19 13 $669.60
90734 135 115 $645.42
90677 155 151 $616.03
92558 53 45 $614.25
96160 429 243 $528.65
90674 344 270 $527.74
96127 141 124 $499.96
99221 12 12 $468.26
93000 47 39 $437.48
90651 39 30 $430.55
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 36 14 $384.70
90744 80 75 $260.00
90648 16 14 $188.75
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 13 13 $176.80
83655 15 12 $132.52
90697 123 112 $120.00
81001 39 28 $57.96
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 312 277 $0.01
96380 13 12 $0.00
1036F 12 12 $0.00
3074F 13 13 $0.00
G8484 Influenza immunization was not administered, reason not given 20,676 16,005 $0.00
G8482 Influenza immunization administered or previously received 4,937 3,664 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 125 118 $0.00