Medicaid Provider Spending

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

SAN MARTIN DE PORRES MEDICAL CLINIC OF SOUTH GATE, INC

NPI: 1134298318 · SOUTH GATE, CA 90280 · General Practice Physician · NPI assigned 11/06/2006

$212K
Total Medicaid Paid
65,566
Total Claims
63,007
Beneficiaries
62
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialCONSIGLIERI, ANA (SUPERVISOR)
NPI Enumeration Date11/06/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 8,497 $41K
2019 12,705 $58K
2020 4,894 $17K
2021 8,145 $30K
2022 9,291 $31K
2023 12,437 $18K
2024 9,597 $18K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 11,052 10,192 $73K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 10,700 10,025 $35K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 793 773 $30K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 505 486 $18K
92552 3,317 3,290 $14K
99384 57 41 $6K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 118 118 $5K
92081 2,510 2,487 $4K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 4,352 4,194 $4K
99383 38 30 $3K
90649 684 677 $3K
85018 2,341 2,242 $2K
90688 452 446 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 822 714 $2K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 564 563 $2K
81003 1,526 1,432 $1K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 15 15 $1K
90734 299 298 $1K
90658 234 228 $1K
97802 2,178 2,168 $1K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 3,710 3,574 $872.93
90715 127 124 $666.00
90648 70 70 $414.00
90670 73 72 $396.00
90710 53 53 $332.08
86580 127 127 $324.52
90633 42 42 $324.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 29 28 $262.88
90686 38 36 $173.83
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 14 14 $137.92
80061 Lipid panel 757 755 $118.47
90460 Immunization administration through 18 years of age via any route, first or only component 264 175 $116.04
90744 13 13 $108.00
90713 12 12 $108.00
90681 12 12 $99.00
3008F 1,469 1,461 $94.06
36415 Collection of venous blood by venipuncture 2,218 2,200 $93.84
83036 Hemoglobin; glycosylated (A1C) 721 719 $86.77
90723 12 12 $63.00
90685 15 15 $45.00
96156 55 53 $30.53
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 225 223 $26.49
1157F 907 902 $23.00
1170F 909 900 $19.73
1160F 1,453 1,443 $11.00
1036F 1,301 1,295 $10.00
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 642 641 $9.51
96150 247 245 $7.76
1100F 809 804 $0.68
G8510 Screening for depression is documented as negative, a follow-up plan is not required 921 917 $0.53
1126F 870 866 $0.00
3074F 989 954 $0.00
1125F 93 91 $0.00
3079F 41 39 $0.00
3075F 18 15 $0.00
3078F 1,298 1,254 $0.00
1159F 1,449 1,440 $0.00
3077F 131 123 $0.00
3288F 785 780 $0.00
1158F 49 48 $0.00
0521F 28 28 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 13 13 $0.00