Medicaid Provider Spending

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

GATEWAY MEDICAL GROUP LC

NPI: 1124012422 · OKEECHOBEE, FL 34972 · Internal Medicine Physician · NPI assigned 09/01/2005

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

Authorized official SMITH, JOHN controls 20+ related entities in our dataset. Read more

$447K
Total Medicaid Paid
21,553
Total Claims
17,145
Beneficiaries
41
Codes Billed
2018-01
First Month
2022-12
Last Month

Provider Details

Authorized OfficialSMITH, JOHN (COO)
NPI Enumeration Date09/01/2005

Related Entities

Other providers sharing the same authorized official: SMITH, JOHN

ProviderCityStateTotal Paid
PRESTIGE HEALTHCARE RESOURCES INC. BLADENSBURG MD $55.74M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $44.35M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $11.62M
PROACT DENTAL, INC. BIRMINGHAM AL $9.47M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $8.33M
DUKE UNIVERSITY HEALTH SYSTEM INC RALEIGH NC $7.84M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $7.61M
WISHON RADIOLOGICAL MEDICAL GROUP, INC. FRESNO CA $5.11M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $5.01M
DUKE UNIVERSITY HEALTH SYSTEM, INC. RALEIGH NC $4.15M
LIGHTHOUSE SYSTEMS, LLC PHARR TX $3.54M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $1.59M
OLD SCHOOL LLC LAKEWOOD OH $800K
TRIANGLE GERIATRIC AND MEMORY CLINIC, PLLC CARY NC $437K
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $289K
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $118K
ASSOCIATED HEALTH SERVICES, INC. DURHAM NC $102K
DUKE HEALTH INTEGRATED PRACTICE, INC. DURHAM NC $64K
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $49K
WOMEN'S IMAGING SPECIALISTS IN HEALTHCARE FRESNO CA $36K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 2,750 $10K
2019 5,612 $140K
2020 4,790 $85K
2021 4,639 $111K
2022 3,762 $102K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3,799 3,374 $176K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 3,665 2,928 $90K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 347 342 $38K
99223 Prolong inpt eval add15 m 597 460 $34K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 257 253 $27K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 241 225 $24K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 120 119 $14K
90460 Immunization administration through 18 years of age via any route, first or only component 1,634 1,591 $13K
99232 Subsequent hospital care, per day, moderate complexity 1,864 466 $8K
97802 520 503 $8K
90472 Immunization administration, each additional vaccine (list separately) 407 401 $8K
90461 53 43 $1K
99309 Subsequent nursing facility care, per day, low to moderate complexity 1,057 703 $1K
99308 Subsequent nursing facility care, per day, straightforward 1,233 563 $1K
85018 1,249 1,220 $983.19
90688 129 129 $721.86
81002 860 837 $698.01
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 47 25 $661.04
90633 130 126 $592.18
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 38 38 $148.80
90670 153 148 $100.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 617 360 $0.00
99173 493 436 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 14 13 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 28 26 $0.00
G0444 Annual depression screening, 5 to 15 minutes 69 68 $0.00
90662 14 12 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 22 12 $0.00
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 630 569 $0.00
92551 469 423 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 67 66 $0.00
94760 336 321 $0.00
90686 46 45 $0.00
90680 39 39 $0.00
96127 27 27 $0.00
G0008 Administration of influenza virus vaccine 72 63 $0.00
90698 51 50 $0.00
3008F 92 71 $0.00
G0442 Annual alcohol misuse screening, 5 to 15 minutes 13 12 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 41 26 $0.00
90716 13 12 $0.00