Medicaid Provider Spending

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

METRO COMMUNITY PROVIDER NETWORK INC

NPI: 1205098340 · AURORA, CO 80010 · Federally Qualified Health Center (FQHC) · NPI assigned 06/30/2008

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

Authorized official PEER, APRIL controls 18+ related entities in our dataset. Read more

$25.62M
Total Medicaid Paid
255,193
Total Claims
218,779
Beneficiaries
133
Codes Billed
2018-01
First Month
2024-08
Last Month

Provider Details

Authorized OfficialPEER, APRIL (CHIEF FINANCIAL OFFICER)
Parent OrganizationMETRO COMMUNITY PROVIDER NETWORK INC
NPI Enumeration Date06/30/2008

Related Entities

Other providers sharing the same authorized official: PEER, APRIL

ProviderCityStateTotal Paid
METRO COMMUNITY PROVIDER NETWORK INC WHEAT RIDGE CO $23.59M
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $11.08M
METRO COMMUNITY PROVIDER NETWORK, INC. AURORA CO $9.74M
METRO COMMUNITY PROVIDER NETWORK INC ARVADA CO $9.29M
METRO COMMUNITY PROVIDER NETWORK INC PARKER CO $3.84M
METRO COMMUNITY PROVIDER NETWORK, INC. ENGLEWOOD CO $3.24M
METRO COMMUNITY PROVIDER NETWORK INC LAKEWOOD CO $3.14M
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $1.35M
METRO COMMUNITY PROVIDER NETWORK, INC. AURORA CO $928K
METRO COMMUNITY PROVIDER NETWORK INC LAKEWOOD CO $865K
METRO COMMUNITY PROVIDER NETWORK, INC. LAKEWOOD CO $560K
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $468K
METRO COMMUNITY PROVIDER NETWORK, INC. GOLDEN CO $464K
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $358K
METRO COMMUNITY PROVIDER NETWORK INC CONIFER CO $241K
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $59K
METRO COMMUNITY PROVIDER NETWORK, INC. AURORA CO $49K
METRO COMMUNITY PROVIDER NETWORK INC WHEAT RIDGE CO $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 45,203 $3.22M
2019 44,603 $2.83M
2020 29,803 $2.99M
2021 30,783 $3.99M
2022 41,299 $5.41M
2023 51,118 $5.74M
2024 12,384 $1.45M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 60,693 50,747 $11.91M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 17,116 14,372 $3.24M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 15,158 13,924 $2.23M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 8,227 7,722 $1.52M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 7,229 6,833 $1.35M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,821 4,502 $908K
H0002 Behavioral health screening to determine eligibility for admission to treatment program 7,156 3,966 $849K
90460 Immunization administration through 18 years of age via any route, first or only component 25,546 18,991 $837K
D0999 Unspecified diagnostic procedure, by report 3,658 3,455 $721K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,576 2,394 $492K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,936 1,712 $403K
H0031 Mental health assessment, by non-physician 1,931 1,020 $248K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,090 987 $217K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 12,531 11,176 $210K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 701 641 $160K
99381 425 397 $92K
90649 744 712 $42K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 171 165 $38K
99215 Prolong outpt/office vis 172 157 $36K
H0023 Behavioral health outreach service (planned approach to reach a targeted population) 247 110 $32K
99441 53 52 $15K
H0001 Alcohol and/or drug assessment 110 41 $15K
90480 91 87 $9K
0081A 173 172 $7K
96110 Developmental screening, with scoring and documentation, per standardized instrument 12,219 11,011 $5K
0124A 129 114 $5K
98966 46 40 $4K
D1120 Prophylaxis - child 603 602 $2K
0082A 60 60 $2K
D1206 Topical application of fluoride varnish 1,327 1,325 $2K
H0006 Alcohol and/or drug services; case management 18 12 $2K
0004A 61 57 $2K
90461 8,764 6,444 $2K
D0272 Bitewings - two radiographic images 523 522 $2K
0071A 44 44 $2K
D0120 Periodic oral evaluation - established patient 634 633 $2K
D0220 Intraoral - periapical first radiographic image 1,182 1,171 $2K
0154A 40 40 $2K
90670 5,094 4,813 $2K
99201 16 12 $1K
D0230 Intraoral - periapical each additional radiographic image 957 956 $1K
99173 5,246 4,919 $1K
0073A 27 27 $1K
90723 2,663 2,478 $1K
90680 2,313 2,174 $907.67
90472 Immunization administration, each additional vaccine (list separately) 862 752 $860.19
99000 1,358 1,190 $821.43
D0150 Comprehensive oral evaluation - new or established patient 275 275 $814.26
0072A 20 19 $782.42
90734 403 372 $733.10
90686 6,815 6,218 $698.87
0173A 20 16 $658.88
90633 1,597 1,456 $641.29
0003A 15 14 $535.34
D1110 Prophylaxis - adult 74 74 $424.56
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 13 13 $386.50
G8510 Screening for depression is documented as negative, a follow-up plan is not required 5,334 4,868 $287.48
D0145 Oral evaluation for a patient under three years of age 266 266 $282.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 150 77 $185.44
D0274 Bitewings - four radiographic images 154 154 $145.60
90696 25 24 $135.00
87800 77 69 $128.46
90716 743 658 $118.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 64 57 $93.00
D1351 Sealant - per tooth 105 33 $75.00
D0140 Limited oral evaluation - problem focused 107 107 $66.00
83655 572 551 $26.92
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month 77 76 $26.70
85018 1,013 963 $23.84
83036 Hemoglobin; glycosylated (A1C) 1,326 1,245 $22.34
84460 40 37 $16.72
80053 Comprehensive metabolic panel 1,156 1,095 $16.44
D0270 27 27 $16.09
84450 13 12 $8.29
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 205 197 $0.00
36415 Collection of venous blood by venipuncture 624 599 $0.00
90647 2,030 1,857 $0.00
H0049 Alcohol and/or drug screening 516 489 $0.00
90651 292 249 $0.00
85025 Blood count; complete (CBC), automated, and automated differential WBC count 871 830 $0.00
91307 90 88 $0.00
84443 Thyroid stimulating hormone (TSH) 393 372 $0.00
91315 42 41 $0.00
36416 804 714 $0.00
90677 797 745 $0.00
90698 246 238 $0.00
91317 28 24 $0.00
80055 12 12 $0.00
90688 586 554 $0.00
87081 45 42 $0.00
86803 44 41 $0.00
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 90 87 $0.00
80048 Basic metabolic panel (calcium, ionized) 62 59 $0.00
94760 248 187 $0.00
86361 13 12 $0.00
90744 84 77 $0.00
86317 17 15 $0.00
90632 69 56 $0.00
87340 46 43 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 46 41 $0.00
D0210 Intraoral - complete series of radiographic images 18 18 $0.00
87086 Culture, bacterial; quantitative colony count, urine 94 92 $0.00
82962 13 12 $0.00
87536 13 12 $0.00
85027 15 13 $0.00
86592 20 18 $0.00
90620 19 15 $0.00
81002 1,032 932 $0.00
90648 321 312 $0.00
81025 1,924 1,509 $0.00
82948 249 221 $0.00
90685 670 638 $0.00
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 157 144 $0.00
90715 1,661 1,477 $0.00
90746 806 737 $0.00
90681 181 162 $0.00
91308 206 187 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 197 186 $0.00
91312 181 163 $0.00
80061 Lipid panel 490 469 $0.00
80305 34 26 $0.00
90713 297 247 $0.00
D0190 442 442 $0.00
90707 121 107 $0.00
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 194 183 $0.00
91300 111 99 $0.00
86682 47 36 $0.00
86735 14 13 $0.00
D0330 Panoramic radiographic image 29 29 $0.00
90700 29 27 $0.00
86480 47 42 $0.00
86787 25 23 $0.00
86708 14 12 $0.00