Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › CA › SACRAMENTO › ELICA HEALTH CENTERS

ELICA HEALTH CENTERS

NPI: 1093974065 · SACRAMENTO, CA 95816 · Case Manager/Care Coordinator · NPI assigned 06/05/2008

$94.19M
Total Medicaid Paid
2,248,837
Total Claims
1,766,554
Beneficiaries
243
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBAK, TATYANA (CEO)
Parent OrganizationELICA HEALTH CENTERS
NPI Enumeration Date06/05/2008

Related Entities

Other providers sharing the same authorized official: BAK, TATYANA

ProviderCityStateTotal Paid
ELICA HEALTH CENTERS NORTH HIGHLANDS CA $58.22M
ELICA HEALTH CENTERS WEST SACRAMENTO CA $42.65M
ELICA HEALTH CENTERS WEST SACRAMENTO CA $3.95M
ELICA HEALTH CENTERS SACRAMENTO CA $2K
ELICA HEALTH CENTERS SACRAMENTO CA $2K
ELICA HEALTH CENTERS SACRAMENTO CA $1K
ELICA HEALTH CENTERS SACRAMENTO CA $650.36
ELICA HEALTH CENTERS SACRAMENTO CA $0.00
ELICA HEALTH CENTERS NORTH HIGHLANDS CA $0.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 134,149 $14.39M
2019 264,340 $15.15M
2020 352,676 $17.19M
2021 403,738 $19.69M
2022 314,411 $12.34M
2023 434,341 $8.75M
2024 345,182 $6.69M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 417,527 359,950 $88.45M
00003 Internal/system code - not a standard HCPCS code 5,525 4,288 $1.33M
G9012 Other specified case management service not elsewhere classified 11,762 5,413 $939K
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 24,756 21,820 $470K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 406,733 275,476 $253K
90791 Psychiatric diagnostic evaluation 6,909 4,738 $240K
D1120 Prophylaxis - child 11,235 10,288 $224K
D1206 Topical application of fluoride varnish 20,161 17,937 $213K
90832 Psychotherapy, 30 minutes with patient 13,335 8,174 $188K
D0150 Comprehensive oral evaluation - new or established patient 12,084 11,337 $140K
D0120 Periodic oral evaluation - established patient 9,898 9,164 $123K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 4,614 3,650 $110K
0012A 3,919 2,297 $102K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 53,157 39,844 $97K
G9008 Coordinated care fee, physician coordinated care oversight services 219 215 $88K
D4341 4,474 2,695 $85K
D2391 Resin-based composite - one surface, posterior, primary or permanent 4,404 3,267 $79K
0011A 3,919 2,404 $78K
D9999 Unspecified adjunctive procedure, by report 869 856 $68K
D9430 9,158 7,856 $66K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 25,979 18,628 $64K
D0210 Intraoral - complete series of radiographic images 7,000 6,533 $64K
D0220 Intraoral - periapical first radiographic image 17,350 15,805 $64K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 140,510 96,420 $57K
D1351 Sealant - per tooth 3,178 1,435 $55K
D1110 Prophylaxis - adult 5,219 4,821 $53K
D0230 Intraoral - periapical each additional radiographic image 16,808 9,155 $47K
90834 Psychotherapy, 45 minutes with patient 2,318 1,232 $43K
D7140 Extraction, erupted tooth or exposed root 2,296 1,604 $40K
D0274 Bitewings - four radiographic images 7,821 7,333 $36K
D1310 13,428 11,471 $33K
D2740 Crown - porcelain/ceramic 106 88 $32K
D4910 477 462 $25K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 6,336 5,640 $16K
90792 Psychiatric diagnostic evaluation with medical services 696 654 $16K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,364 1,782 $15K
0064A 758 540 $11K
D0603 10,356 9,761 $11K
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month 4,506 4,421 $10K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 9,147 6,674 $9K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 1,369 890 $9K
D0240 1,184 578 $9K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 5,454 4,139 $8K
D0145 Oral evaluation for a patient under three years of age 1,006 884 $8K
G0466 Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 334 324 $8K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 8,002 5,663 $7K
D0330 Panoramic radiographic image 1,902 1,669 $7K
98940 7,792 3,491 $7K
99383 3,387 2,513 $6K
D0140 Limited oral evaluation - problem focused 2,653 2,460 $5K
D0272 Bitewings - two radiographic images 1,300 1,140 $5K
D0270 4,131 3,736 $5K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 68,659 53,273 $4K
D9110 396 302 $4K
D0999 Unspecified diagnostic procedure, by report 65 65 $4K
96127 30,972 26,249 $4K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 4,028 3,011 $3K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 374 340 $3K
D9993 8,655 8,325 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 3,945 2,714 $2K
99384 1,682 1,192 $2K
90688 7,110 5,005 $2K
90715 8,682 6,411 $2K
D0160 24 24 $2K
90472 Immunization administration, each additional vaccine (list separately) 24,340 18,755 $2K
96160 11,075 7,868 $2K
97803 1,537 1,222 $1K
99215 Prolong outpt/office vis 2,209 1,712 $1K
90670 4,984 3,649 $1K
96156 10,561 6,526 $1K
90480 226 222 $1K
92551 15,539 10,359 $1K
D0602 2,253 2,156 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 4,344 2,319 $1K
85018 14,948 11,912 $1K
99173 20,260 13,969 $1K
97802 1,436 1,314 $836.74
99205 Prolong outpt/office vis 123 88 $824.98
90686 23,559 17,616 $792.06
90658 281 242 $790.87
D0601 1,001 940 $789.00
83036 Hemoglobin; glycosylated (A1C) 19,983 13,956 $781.75
99385 635 408 $742.80
92552 3,427 2,641 $677.92
0071A 131 97 $636.00
99382 825 551 $583.36
93000 3,816 2,491 $531.45
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 836 616 $529.89
90460 Immunization administration through 18 years of age via any route, first or only component 2,193 2,081 $511.60
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 5,110 4,818 $501.99
36415 Collection of venous blood by venipuncture 467 447 $432.92
90461 812 759 $425.64
90744 1,287 1,059 $378.54
90746 141 126 $283.27
0002A 17 12 $268.00
90710 2,955 2,077 $263.82
81000 104 98 $258.84
D0350 1,106 1,012 $249.60
0052A 14 12 $241.00
0004A 18 13 $201.00
0072A 32 29 $201.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 608 455 $179.84
D1352 78 67 $142.00
90697 222 181 $139.78
99381 134 104 $133.43
98941 Chiropractic manipulative treatment; spinal, 3-4 regions 72 29 $122.07
90739 614 576 $121.70
90662 70 60 $109.75
80053 Comprehensive metabolic panel 105 105 $107.00
90698 339 312 $104.19
D1320 346 219 $90.00
90633 6,665 4,899 $89.47
90713 1,513 1,208 $76.83
90656 1,226 1,143 $48.22
92587 1,867 1,324 $46.07
81025 3,559 2,351 $39.33
81002 8,583 5,516 $30.10
V2020 Frames, purchases 77 77 $21.31
83655 567 458 $21.26
G0008 Administration of influenza virus vaccine 469 432 $20.77
80305 436 236 $19.08
90716 1,851 1,516 $17.95
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 528 363 $13.98
83026 11,633 7,226 $13.46
90696 607 436 $13.42
99386 283 201 $10.72
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 115 70 $8.85
82962 1,666 1,202 $7.89
99441 8,475 5,987 $7.20
86580 313 219 $3.36
90653 155 130 $3.00
90672 1,498 966 $0.05
90651 3,470 2,410 $0.03
1159F 25,381 23,699 $0.00
99177 3,010 2,199 $0.00
90700 703 517 $0.00
1160F 20,826 19,296 $0.00
3078F 93,338 81,049 $0.00
3077F 24,887 21,269 $0.00
90648 3,305 2,279 $0.00
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 1,567 1,130 $0.00
99188 1,880 1,202 $0.00
99442 7,231 6,196 $0.00
3046F 493 429 $0.00
99401 371 371 $0.00
90734 1,642 1,140 $0.00
91321 59 59 $0.00
90473 351 223 $0.00
D9991 56 39 $0.00
90681 398 293 $0.00
3051F 488 426 $0.00
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit 381 360 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 15 12 $0.00
4004F 2,943 2,861 $0.00
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 235 235 $0.00
D9986 973 918 $0.00
91300 151 133 $0.00
D9987 195 188 $0.00
92015 Determination of refractive state 235 235 $0.00
3050F 99 97 $0.00
90707 511 412 $0.00
90671 62 62 $0.00
D9996 78 77 $0.00
G0444 Annual depression screening, 5 to 15 minutes 186 171 $0.00
D5110 31 31 $0.00
90685 80 80 $0.00
17110 14 13 $0.00
90621 53 29 $0.00
D9990 63 54 $0.00
91322 12 12 $0.00
D2950 49 47 $0.00
90649 55 34 $0.00
D1354 13 13 $0.00
11721 29 29 $0.00
80061 Lipid panel 28 28 $0.00
T1013 Sign language or oral interpretive services, per 15 minutes 104 55 $0.00
D2332 12 12 $0.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 23 13 $0.00
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 21 12 $0.00
81003 25 13 $0.00
99199 Unlisted special service, procedure or report 15 15 $0.00
S9470 Nutritional counseling, dietitian visit 12 12 $0.00
3075F 17,862 15,463 $0.00
3079F 33,368 29,082 $0.00
1125F 1,468 1,421 $0.00
D1330 22,135 19,634 $0.00
3080F 12,151 10,176 $0.00
3074F 96,644 83,794 $0.00
3008F 135,403 116,091 $0.00
3052F 37 37 $0.00
90723 3,235 2,251 $0.00
90474 199 123 $0.00
3044F 3,732 3,286 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 151 147 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 597 221 $0.00
4010F 3,050 2,805 $0.00
91307 256 215 $0.00
90677 591 485 $0.00
92250 1,565 1,078 $0.00
1170F 437 415 $0.00
D5899 869 565 $0.00
3049F 54 54 $0.00
V2782 Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens 64 64 $0.00
96150 958 558 $0.00
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 124 79 $0.00
J1885 Injection, ketorolac tromethamine, per 15 mg 285 187 $0.00
91301 220 195 $0.00
90647 282 204 $0.00
99406 234 201 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 303 282 $0.00
99443 1,270 1,149 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 82 76 $0.00
1126F 277 246 $0.00
90732 214 168 $0.00
91306 645 560 $0.00
3061F 15 15 $0.00
D2330 76 71 $0.00
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 29 29 $0.00
96151 120 71 $0.00
90694 421 359 $0.00
1036F 220 219 $0.00
1101F 134 127 $0.00
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 32 32 $0.00
90680 136 97 $0.00
G9664 Patients who are currently statin therapy users or received an order (prescription) for statin therapy 50 49 $0.00
D2331 91 84 $0.00
90620 58 38 $0.00
D0171 106 104 $0.00
H0049 Alcohol and/or drug screening 240 239 $0.00
G0442 Annual alcohol misuse screening, 5 to 15 minutes 38 37 $0.00
99402 29 28 $0.00
D4342 15 12 $0.00
3048F 53 48 $0.00
90619 27 16 $0.00
99403 31 31 $0.00
G0009 Administration of pneumococcal vaccine 15 12 $0.00
99283 Emergency department visit for the evaluation and management, moderate severity 161 146 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 45 41 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 20 20 $0.00
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 19 15 $0.00
91305 18 18 $0.00
V2200 Sphere, bifocal, plano to plus or minus 4.00d, per lens 16 16 $0.00
90660 25 13 $0.00