Medicaid Provider Spending

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

WESTERN NEW YORK MEDICAL PRACTICE P.C.

NPI: 1063790608 · ROCHESTER, NY 14621 · Pediatrics Physician · NPI assigned 08/01/2011

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

Authorized official TINCH, PAULA controls 20+ related entities in our dataset. Read more

$13.41M
Total Medicaid Paid
213,682
Total Claims
200,459
Beneficiaries
127
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialTINCH, PAULA (SVP- FINANCE)
NPI Enumeration Date08/01/2011

Related Entities

Other providers sharing the same authorized official: TINCH, PAULA

ProviderCityStateTotal Paid
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $226.97M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $25.15M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $21.62M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $14.54M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $14.22M
ROCHESTER GENERAL HOSPITAL SODUS NY $11.31M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $10.05M
BEHAVIORAL HEALTH NETWORK, INC. ROCHESTER NY $6.84M
WESTERN NEW YORK MEDICAL PRACTICE, P.C. GENEVA NY $6.32M
CLIFTON SPRINGS SANITARIUM CO CLIFTON SPRINGS NY $1.80M
NEWARK WAYNE COMMUNITY HOSPITAL-LAB NEWARK NY $1.61M
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC MECHANICSBURG PA $366K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $281K
NEWARK WAYNE COMMUNITY HOSPITAL NEWARK NY $176K
ROCHESTER GENERAL HOSPITAL WEBSTER NY $135K
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC CAMP HILL PA $56K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $54K
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC HARRISBURG PA $23K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $9K
WESTERN NEW YORK MEDICAL PRACTICE PC ROCHESTER NY $9K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 8,182 $460K
2019 15,679 $846K
2020 27,542 $1.58M
2021 41,079 $2.71M
2022 43,183 $2.88M
2023 51,813 $3.35M
2024 26,204 $1.59M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 98,138 94,116 $6.32M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 37,936 36,362 $3.79M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 9,277 9,260 $823K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 4,027 4,015 $526K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials 748 745 $146K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,214 1,214 $124K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 3,369 3,157 $123K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,071 1,069 $109K
95117 10,241 4,362 $89K
20610 1,493 1,457 $82K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 685 684 $78K
90460 Immunization administration through 18 years of age via any route, first or only component 4,242 3,852 $74K
0002A 1,750 1,750 $69K
73630 2,453 2,281 $69K
20611 839 799 $68K
99215 Prolong outpt/office vis 470 470 $63K
0001A 1,705 1,705 $62K
V2020 Frames, purchases 1,398 1,382 $61K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 663 609 $57K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 473 473 $45K
78815 Positron emission tomography (PET) for limited area imaging 40 40 $45K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 191 191 $40K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 241 241 $40K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 644 633 $32K
72110 716 715 $28K
92557 874 873 $27K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 409 385 $25K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 212 212 $23K
81000 6,406 6,174 $23K
99442 395 368 $21K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 318 317 $20K
99205 Prolong outpt/office vis 94 94 $18K
92567 1,112 1,105 $15K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,537 1,532 $14K
51798 1,260 1,237 $13K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 192 191 $13K
73564 321 317 $13K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,058 1,051 $12K
73562 343 337 $11K
90686 1,652 1,651 $10K
73030 379 366 $10K
93299 54 54 $9K
73110 269 253 $9K
92550 433 430 $7K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 39 39 $7K
99152 366 362 $7K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 105 105 $7K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 52 52 $7K
64483 48 44 $6K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 120 117 $6K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 228 225 $6K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 38 38 $5K
J1020 Injection, methylprednisolone acetate, 20 mg 702 690 $5K
73610 178 175 $5K
J1030 Injection, methylprednisolone acetate, 40 mg 619 596 $5K
93298 229 228 $5K
11721 177 176 $4K
31231 25 25 $4K
77067 Screening mammography, bilateral, including computer-aided detection 37 37 $3K
L4361 Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf 17 17 $3K
99460 37 37 $3K
73140 104 98 $3K
52000 17 17 $3K
67028 Intravitreal injection of a pharmacologic agent 25 24 $3K
96110 Developmental screening, with scoring and documentation, per standardized instrument 522 521 $3K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 799 779 $3K
92015 Determination of refractive state 208 208 $3K
71046 Radiologic examination, chest; 2 views 107 107 $3K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 60 24 $3K
11900 52 50 $2K
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf 37 36 $2K
99308 Subsequent nursing facility care, per day, straightforward 59 43 $2K
99406 132 124 $2K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 57 57 $2K
81002 596 559 $2K
73130 53 52 $2K
L1902 Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf 36 36 $2K
J2795 Injection, ropivacaine hydrochloride, 1 mg 483 420 $2K
92551 188 187 $2K
0071A 35 35 $1K
93000 137 136 $1K
69210 42 40 $1K
90935 Hemodialysis procedure with single evaluation by a physician 34 13 $1K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 13 12 $1K
G0008 Administration of influenza virus vaccine 167 167 $935.91
99238 Hospital discharge day management, 30 minutes or less 13 13 $889.22
97803 16 14 $862.40
82947 227 204 $837.91
80305 85 72 $834.86
0072A 19 19 $806.30
64484 17 14 $759.42
95251 43 43 $750.67
99051 105 105 $736.45
90682 12 12 $716.18
99441 32 31 $706.52
72170 31 31 $697.42
92588 12 12 $641.05
83036 Hemoglobin; glycosylated (A1C) 64 64 $593.50
90656 45 45 $494.13
96127 107 106 $459.51
99173 601 601 $455.96
90688 25 25 $448.17
36415 Collection of venous blood by venipuncture 2,877 2,800 $412.01
92250 12 12 $403.18
0012A 19 19 $399.74
J1040 Injection, methylprednisolone acetate, 80 mg 25 25 $352.59
J1010 Injection, methylprednisolone acetate, 1 mg 40 37 $340.69
S0580 Polycarbonate lens (list this code in addition to the basic code for the lens) 14 14 $280.00
77003 14 13 $278.19
90670 120 120 $254.09
90619 15 15 $193.31
83655 14 14 $164.69
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 14 14 $154.97
81025 40 40 $152.31
99177 99 99 $123.78
85018 27 27 $60.13
82962 14 14 $42.49
94760 231 224 $36.99
J1100 Injection, dexamethasone sodium phosphate, 1 mg 12 12 $13.20
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 28 28 $0.24
99024 76 69 $0.00
90697 42 42 $0.00
90651 39 39 $0.00
90680 41 41 $0.00
90734 36 36 $0.00
90633 24 24 $0.00
90461 33 33 $0.00