Medicaid Provider Spending

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

DFW PRIMARY CARE PLLC

NPI: 1063835361 · IRVING, TX 75038 · In Home Supportive Care Agency · NPI assigned 01/23/2014

$35K
Total Medicaid Paid
1,140
Total Claims
941
Beneficiaries
6
Codes Billed
2020-10
First Month
2023-09
Last Month

Provider Details

Authorized OfficialKETHA, SUMANA (PRESIDENT)
NPI Enumeration Date01/23/2014

Related Entities

Other providers sharing the same authorized official: KETHA, SUMANA

ProviderCityStateTotal Paid
DFW MEDICAL HOME PLLC IRVING TX $1.05M
SUMANA KETHA, MD PA IRVING TX $45K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 184 $5K
2021 407 $13K
2022 468 $14K
2023 81 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 736 622 $27K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 298 218 $7K
90674 45 41 $849.91
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 29 28 $181.06
99497 16 16 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 16 16 $0.00