Medicaid Provider Spending

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

SAN LUCAS PEDIATRIC CLINIC, INC.

NPI: 1073870283 · SACRAMENTO, CA 95834 · Pediatrics Physician · NPI assigned 04/12/2012

$529K
Total Medicaid Paid
353,443
Total Claims
343,228
Beneficiaries
68
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialAREVALO, MANUEL (PRESIDENT)
NPI Enumeration Date04/12/2012

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 38,474 $163K
2019 67,517 $8K
2020 52,305 $242.84
2021 66,587 $70.00
2022 65,552 $31K
2023 31,882 $215K
2024 31,126 $112K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
96110 Developmental screening, with scoring and documentation, per standardized instrument 32,544 31,690 $134K
96156 18,225 18,116 $91K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 9,708 9,437 $67K
G9920 Screening performed and negative 5,479 5,471 $59K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 8,709 8,531 $49K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 5,973 5,846 $21K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 3,618 3,481 $15K
92551 20,006 19,441 $13K
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 25,606 24,773 $8K
99383 550 497 $7K
97802 23,917 23,224 $6K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 16,148 15,404 $6K
99401 28,893 28,061 $6K
99188 1,621 1,595 $6K
86580 9,349 8,970 $4K
85018 13,788 13,206 $4K
D0120 Periodic oral evaluation - established patient 22,639 22,097 $4K
90686 8,667 8,536 $4K
99173 20,403 19,854 $3K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 4,114 3,950 $3K
90460 Immunization administration through 18 years of age via any route, first or only component 6,522 6,288 $2K
90651 2,857 2,781 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 8,123 7,670 $2K
G9919 Screening performed and positive and provision of recommendations 159 159 $2K
97803 6,072 5,944 $2K
90472 Immunization administration, each additional vaccine (list separately) 1,744 1,509 $1K
99382 182 177 $1K
90716 2,680 2,629 $737.84
90733 523 471 $692.53
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 5,194 4,901 $651.41
90670 3,526 3,385 $576.92
90461 5,925 5,875 $548.27
90744 1,931 1,848 $480.03
90707 2,576 2,525 $452.35
90633 3,019 2,966 $411.30
90700 2,051 1,974 $319.43
99384 197 197 $318.53
90710 55 55 $275.20
90619 403 403 $267.00
90620 1,337 1,317 $200.00
90680 1,934 1,855 $188.72
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 78 78 $160.00
90697 215 215 $157.08
90685 610 591 $153.24
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 3,046 2,934 $135.82
D1206 Topical application of fluoride varnish 2,413 2,403 $118.12
90696 1,139 1,121 $116.40
90713 792 767 $111.35
90715 1,282 1,269 $95.27
90698 1,553 1,492 $89.86
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 374 369 $55.36
90647 1,696 1,633 $54.00
90671 362 362 $36.27
90734 1,809 1,802 $18.00
90650 536 527 $0.00
94760 63 59 $0.00
86403 101 96 $0.00
90480 13 13 $0.00
0081A 14 14 $0.00
99381 14 12 $0.00
91307 41 39 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 156 155 $0.00
87631 61 61 $0.00
90681 32 32 $0.00
91308 32 31 $0.00
91312 15 15 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 13 13 $0.00
91320 16 16 $0.00