Medicaid Provider Spending

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

1104971449

NPI: 1104971449

Deactivated NPI · This NPI was deactivated on 12/02/2025.
$119K
Total Medicaid Paid
20,763
Total Claims
17,617
Beneficiaries
85
Codes Billed
2018-01
First Month
2018-12
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 20,763 $119K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99444 1,185 375 $67K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 160 160 $10K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,153 1,586 $8K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 214 214 $5K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 654 576 $5K
93922 496 475 $4K
93882 205 204 $2K
99497 258 254 $2K
93976 88 77 $2K
20611 285 271 $2K
93923 236 236 $2K
20553 362 327 $1K
76536 146 145 $1K
95250 129 128 $1K
95251 132 132 $731.50
93880 41 41 $694.77
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 365 306 $687.42
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 72 63 $492.10
94060 171 166 $489.11
93925 19 19 $488.79
93224 72 72 $427.45
71046 Radiologic examination, chest; 2 views 222 215 $268.00
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 12 12 $208.28
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 256 241 $206.72
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 223 216 $154.69
83880 28 26 $140.80
80053 Comprehensive metabolic panel 579 561 $120.71
83036 Hemoglobin; glycosylated (A1C) 461 457 $115.25
93701 17 16 $100.90
76705 Ultrasound, abdominal, real time with image documentation; limited 77 77 $88.30
73030 60 57 $72.17
51701 13 13 $71.65
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 13 12 $69.99
84443 Thyroid stimulating hormone (TSH) 124 124 $58.08
92567 167 159 $55.98
82553 92 87 $55.02
84484 92 87 $53.22
72050 97 94 $49.35
84480 96 96 $49.02
J0696 Injection, ceftriaxone sodium, per 250 mg 75 67 $37.17
72110 45 44 $36.89
20552 13 12 $34.86
72070 14 14 $32.16
82044 389 387 $31.48
84439 96 96 $31.17
81003 717 685 $31.07
86430 26 25 $23.52
80061 Lipid panel 209 209 $20.07
84550 30 30 $18.76
73560 40 39 $13.60
82948 1,186 830 $11.53
80048 Basic metabolic panel (calcium, ionized) 323 302 $9.74
83735 19 17 $6.95
86140 12 12 $5.37
51798 30 30 $4.80
84100 19 17 $4.56
J1100 Injection, dexamethasone sodium phosphate, 1 mg 57 50 $1.62
J1020 Injection, methylprednisolone acetate, 20 mg 360 319 $0.00
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes 161 160 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 169 159 $0.00
1090F 257 253 $0.00
3288F 257 253 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 142 133 $0.00
76775 14 14 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 216 131 $0.00
74018 61 59 $0.00
G0246 Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education 43 43 $0.00
99490 Ccm add 20min 101 101 $0.00
86677 85 83 $0.00
77080 79 77 $0.00
85025 Blood count; complete (CBC), automated, and automated differential WBC count 539 460 $0.00
1126F 1,654 1,278 $0.00
1170F 258 254 $0.00
90688 140 140 $0.00
76700 Ultrasound, abdominal, real time with image documentation; complete 24 24 $0.00
J1030 Injection, methylprednisolone acetate, 40 mg 347 306 $0.00
86063 12 12 $0.00
36415 Collection of venous blood by venipuncture 753 677 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 256 252 $0.00
G0008 Administration of influenza virus vaccine 140 140 $0.00
1125F 1,156 918 $0.00
3044F 42 41 $0.00
3061F 18 18 $0.00
G8430 Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status) 95 57 $0.00
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 12 12 $0.00