Medicaid Provider Spending

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

SUMNER PHYSICIAN PRACTICES, LLC

NPI: 1083097711 · GALLATIN, TN 37066 · Family Medicine Physician · NPI assigned 06/30/2015

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

Authorized official LAWRENCE, CHARLOTTE controls 20+ related entities in our dataset. Read more

$266K
Total Medicaid Paid
23,149
Total Claims
17,708
Beneficiaries
21
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLAWRENCE, CHARLOTTE (SECRETARY)
NPI Enumeration Date06/30/2015

Related Entities

Other providers sharing the same authorized official: LAWRENCE, CHARLOTTE

ProviderCityStateTotal Paid
LAKE CUMBERLAND REGIONAL HOSPITAL LLC SOMERSET KY $77.77M
DANVILLE REGIONAL MEDICAL CENTER, LLC DANVILLE VA $65.11M
PHC-LAS CRUCES INC LAS CRUCES NM $64.77M
GEORGETOWN COMMUNITY HOSPITAL LLC GEORGETOWN KY $44.03M
PINELAKE REGIONAL HOSPITAL LLC MAYFIELD KY $43.34M
RALEIGH GENERAL HOSPITAL LLC BECKLEY WV $36.44M
LOURDES HOSPITAL LLC PASCO WA $33.94M
RCHP-SIERRA VISTA INC SIERRA VISTA AZ $29.77M
CLINCH VALLEY MEDICAL CENTER INC. RICHLANDS VA $26.28M
SPRING VIEW HOSPITAL LLC LEBANON KY $23.35M
HAVASU REGIONAL MEDICAL CENTER LLC LAKE HAVASU CITY AZ $23.19M
LAS CRUCES PHYSICIAN PRACTICES, LLC LAS CRUCES NM $22.78M
MEADOWVIEW REGIONAL MEDICAL CENTER LLC MAYSVILLE KY $22.57M
LOURDES HOSPITAL LLC RICHLAND WA $22.38M
DANVILLE REGIONAL MEDICAL CENTER LLC MARTINSVILLE VA $21.09M
PHC-FORT MOHAVE INC FORT MOHAVE AZ $19.95M
WYTHE COUNTY COMMUNITY HOSPITAL LLC WYTHEVILLE VA $18.30M
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC JOHNSTOWN PA $18.22M
BOURBON COMMUNITY HOSPITAL LLC PARIS KY $18.14M
WILLAMETTE VALLEY MEDICAL CENTER LLC MCMINNVILLE OR $17.29M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,066 $46K
2019 1,064 $37K
2020 495 $19K
2021 555 $23K
2022 4,893 $31K
2023 5,875 $41K
2024 9,201 $69K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,599 3,584 $205K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,433 1,194 $51K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 614 445 $3K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 28 24 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 190 121 $2K
90686 109 65 $1K
90674 50 37 $559.95
3074F 1,899 1,453 $503.98
96127 197 136 $429.10
3078F 1,502 1,133 $413.39
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 12 12 $129.31
3079F 158 130 $104.98
3075F 58 38 $40.00
1160F 2,195 1,692 $0.00
1159F 2,200 1,698 $0.00
3725F 102 80 $0.00
3008F 3,946 2,973 $0.00
1036F 2,776 2,061 $0.00
1125F 193 152 $0.00
1034F 146 116 $0.00
1126F 742 564 $0.00