PRIME HEALTHCARE, PC

$4.27M

Total Medicaid Paid

204,600

Total Claims

183,308

Beneficiaries

80

Codes Billed

2018-01

First Month

2024-12

Last Month

Authorized Official	ALBANO, SUSAN (CEO)
NPI Enumeration Date	09/11/2007

Year	Claims	Total Paid
2018	30,813	$581K
2019	27,965	$591K
2020	21,583	$468K
2021	27,966	$582K
2022	34,277	$697K
2023	34,886	$725K
2024	27,110	$630K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	42,172	37,801	$2.07M
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	32,973	28,924	$1.16M
99308	Subsequent nursing facility care, per day, straightforward	6,863	6,121	$248K
99349		5,412	4,290	$191K
99305		1,080	967	$72K
99309	Subsequent nursing facility care, per day, low to moderate complexity	1,221	1,061	$60K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	1,017	933	$49K
99307		2,435	2,299	$45K
99223	Prolong inpt eval add15 m	525	486	$36K
99336		932	658	$31K
99244	Office or other outpatient consultation, moderate to high complexity	263	240	$29K
99487	Ccm add 20min	1,627	1,599	$29K
99215	Prolong outpt/office vis	432	359	$21K
76770		783	697	$20K
99232	Subsequent hospital care, per day, moderate complexity	956	528	$19K
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	1,970	1,920	$18K
94010		1,737	1,631	$14K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	91	86	$12K
82570		4,263	3,720	$11K
99489	Ccm add 20min	527	514	$10K
99350	Prolong home eval add 15m	257	206	$9K
83036	Hemoglobin; glycosylated (A1C)	2,313	2,134	$9K
99490	Ccm add 20min	1,063	1,051	$9K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	66	64	$9K
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	759	730	$9K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	374	349	$8K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	124	119	$7K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	165	163	$7K
99491	Ccm add 20min	399	394	$6K
51798		1,215	1,068	$6K
96127		283	246	$5K
90674		236	232	$5K
99245		31	29	$4K
82962		4,458	4,095	$4K
94729		568	540	$4K
90460	Immunization administration through 18 years of age via any route, first or only component	105	102	$3K
93000		341	323	$3K
99233	Prolong inpt eval add15 m	83	46	$3K
94375		607	535	$3K
99254		31	29	$3K
94727		441	417	$3K
99306	Prolong nursin fac eval 15m	26	24	$3K
95251		228	213	$2K
99231	Subsequent hospital care, per day, straightforward or low complexity	172	85	$2K
52000		26	25	$1K
99442		55	40	$1K
90686		193	172	$989.56
99497		63	52	$765.82
99222	Initial hospital care, per day, moderate complexity	14	14	$660.33
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	17	14	$569.00
94060		65	59	$475.02
81003		1,298	1,137	$471.90
90756		30	27	$468.61
95800		14	13	$405.54
99337		15	12	$390.70
96110	Developmental screening, with scoring and documentation, per standardized instrument	13	12	$290.16
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)	113	100	$224.02
98926		13	12	$215.19
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	333	304	$171.29
99173		13	12	$91.20
81002		273	241	$90.28
3017F		4,012	3,624	$0.00
1036F		9,145	8,317	$0.00
G8419	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	20,629	18,926	$0.00
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	1,157	1,071	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	7,486	6,627	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	469	416	$0.00
G8755	Most recent diastolic blood pressure >= 90 mmhg	130	120	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	187	181	$0.00
3044F		37	36	$0.00
G0008	Administration of influenza virus vaccine	41	37	$0.00
G8783	Normal blood pressure reading documented, follow-up not required	27,781	25,201	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	3,403	3,111	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	5,538	4,992	$0.00
G8753	Most recent systolic blood pressure >= 140 mmhg	139	125	$0.00
1033F		12	12	$0.00
G8482	Influenza immunization administered or previously received	196	174	$0.00
G8483	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	40	38	$0.00
3045F		12	12	$0.00
G0444	Annual depression screening, 5 to 15 minutes	14	14	$0.00

Medicaid Provider Spending

Provider Details

Monthly Spending Trend

Yearly Breakdown

Billing Codes