Medicaid Provider Spending

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

KARELIS, THOMAS

NPI: 1053324129 · HAZARD, KY 41701 · Internal Medicine Physician · NPI assigned 08/13/2006

$1.04M
Total Medicaid Paid
31,702
Total Claims
26,697
Beneficiaries
24
Codes Billed
2019-12
First Month
2024-12
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 143 $37.57
2020 7,209 $276K
2021 7,779 $232K
2022 6,314 $176K
2023 5,911 $209K
2024 4,346 $149K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 12,537 10,326 $314K
G0483 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; 22 or more drug class(es), including metabolite(s) if performed 1,158 1,100 $173K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6,432 5,392 $170K
27096 542 450 $141K
G0481 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; 8-14 drug class(es), including metabolite(s) if performed 1,133 1,042 $84K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,783 1,526 $70K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,303 2,008 $47K
72131 89 87 $14K
72192 75 73 $9K
72125 Computed tomography, cervical spine; without contrast material 34 33 $6K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 791 716 $6K
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 57 53 $3K
J1030 Injection, methylprednisolone acetate, 40 mg 344 296 $2K
20552 43 37 $806.40
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 331 282 $443.17
S0020 Injection, bupivicaine hydrochloride, 30 ml 655 551 $219.14
36415 Collection of venous blood by venipuncture 78 60 $16.90
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 176 156 $4.98
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 822 646 $1.22
J3490 Unclassified drugs 101 90 $1.06
G9583 Patients prescribed opiates for longer than six weeks 811 639 $0.01
G8730 Pain assessment documented as positive using a standardized tool and a follow-up plan is documented 439 371 $0.00
G9578 Documentation of signed opioid treatment agreement at least once during opioid therapy 825 648 $0.00
G9562 Patients who had a follow-up evaluation conducted at least every three months during opioid therapy 143 115 $0.00