Medicaid Provider Spending

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

VILLAGE PEDIATRICS OF ST AUGUSTINE LLC

NPI: 1164738191 · ST AUGUSTINE, FL 32092 · Pediatrics Physician · NPI assigned 08/27/2010

$9K
Total Medicaid Paid
229
Total Claims
206
Beneficiaries
5
Codes Billed
2019-02
First Month
2019-12
Last Month

Provider Details

Authorized OfficialELVIR, PATRICIA (OWNER)
NPI Enumeration Date08/27/2010

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 229 $9K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 120 104 $7K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 45 38 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 13 13 $120.50
85018 27 27 $0.00
96160 24 24 $0.00