Medicaid Provider Spending

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

EMPIRE HEALTH SYSTEMS

NPI: 1134856982 · LAS VEGAS, NV 89146 · Family Medicine Physician · NPI assigned 08/02/2022

$13K
Total Medicaid Paid
27,257
Total Claims
9,630
Beneficiaries
45
Codes Billed
2022-08
First Month
2024-11
Last Month

Provider Details

Authorized OfficialGUSTILO, JINGLAN (SECRETARY)
NPI Enumeration Date08/02/2022

Related Entities

Other providers sharing the same authorized official: GUSTILO, JINGLAN

ProviderCityStateTotal Paid
VEGAS MD LAS VEGAS NV $10K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 941 $2K
2023 14,115 $10K
2024 12,201 $622.40

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 2,792 1,342 $3K
99489 Ccm add 20min 100 100 $2K
99487 Ccm add 20min 105 101 $2K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 401 212 $972.50
95957 41 36 $869.06
97032 2,654 777 $760.17
99457 126 122 $590.64
99458 120 117 $486.80
99454 102 95 $461.57
95004 Percutaneous tests with allergenic extracts, immediate type reaction 13 13 $452.34
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) 361 248 $376.20
99215 Prolong outpt/office vis 644 453 $304.76
95930 41 36 $268.83
95816 41 36 $234.49
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 21 14 $134.33
92652 41 36 $99.29
97016 2,305 643 $98.72
96137 41 36 $43.79
96136 41 36 $30.26
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 2,303 643 $27.20
96112 226 210 $20.92
93040 41 36 $8.41
96375 Therapeutic injection; each additional sequential IV push 1,132 464 $5.31
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1,132 464 $2.27
96367 1,132 464 $0.34
96368 1,132 464 $0.02
96116 239 222 $0.00
99490 Ccm add 20min 160 155 $0.00
J3415 Injection, pyridoxine hcl, 100 mg 1,114 452 $0.00
93015 54 47 $0.00
99453 91 83 $0.00
G0444 Annual depression screening, 5 to 15 minutes 27 24 $0.00
93970 36 29 $0.00
J3490 Unclassified drugs 6,501 464 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,122 453 $0.00
93000 89 79 $0.00
96132 41 36 $0.00
99406 71 64 $0.00
76700 Ultrasound, abdominal, real time with image documentation; complete 24 12 $0.00
95115 375 98 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 18 17 $0.00
G0442 Annual alcohol misuse screening, 5 to 15 minutes 70 63 $0.00
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials 76 76 $0.00
99439 47 44 $0.00
99205 Prolong outpt/office vis 14 14 $0.00