Medicaid Provider Spending

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

UPSTATE FAMILY HEALTH CENTER INCORPORATED

NPI: 1205203023 · UTICA, NY 13502 · Clinic/Center · NPI assigned 08/27/2015

$13.80M
Total Medicaid Paid
190,732
Total Claims
152,586
Beneficiaries
101
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialSCHMIDT, WANDA (OPERATIONS MANAGER)
NPI Enumeration Date08/27/2015

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12,374 $1.22M
2019 21,237 $1.90M
2020 20,774 $1.52M
2021 28,831 $2.36M
2022 41,284 $2.66M
2023 45,022 $2.56M
2024 21,210 $1.57M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 74,745 57,788 $8.18M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 18,628 15,903 $2.04M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 12,030 6,738 $1.04M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,778 3,150 $509K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2,923 2,435 $359K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 3,351 1,583 $256K
11721 1,558 1,504 $256K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,212 1,177 $195K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 886 819 $138K
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 8,787 4,206 $138K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,038 958 $137K
96127 5,670 5,375 $82K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 507 427 $58K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 286 285 $49K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 1,148 754 $45K
36415 Collection of venous blood by venipuncture 8,530 8,106 $34K
0001A 499 484 $28K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 5,494 5,408 $28K
0012A 348 330 $26K
0002A 290 285 $21K
0011A 454 431 $19K
T1013 Sign language or oral interpretive services, per 15 minutes 1,355 1,274 $18K
90832 Psychotherapy, 30 minutes with patient 159 101 $17K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 88 88 $16K
90834 Psychotherapy, 45 minutes with patient 103 77 $14K
99385 107 96 $13K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 70 48 $8K
99384 73 51 $7K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 611 556 $6K
0013A 136 134 $5K
90688 755 753 $4K
99406 2,353 2,184 $4K
90791 Psychiatric diagnostic evaluation 27 27 $4K
0003A 103 102 $4K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 170 82 $4K
90837 Psychotherapy, 53 minutes with patient 19 13 $3K
99441 53 48 $3K
98941 Chiropractic manipulative treatment; spinal, 3-4 regions 548 374 $3K
99495 96 96 $3K
99173 732 719 $2K
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 3,265 3,004 $2K
98926 279 249 $2K
90674 138 136 $2K
99442 39 35 $2K
90472 Immunization administration, each additional vaccine (list separately) 2,086 2,053 $1K
99383 16 13 $1K
80305 908 682 $1K
99382 15 14 $1K
90670 530 528 $1K
90633 266 265 $1K
0052A 21 21 $973.85
82962 628 587 $923.49
G8420 Bmi is documented within normal parameters and no follow-up plan is required 1,646 1,511 $877.51
90715 158 157 $861.25
92250 101 99 $780.25
0072A 16 16 $773.85
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 188 185 $702.48
90651 99 99 $519.51
G8510 Screening for depression is documented as negative, a follow-up plan is not required 4,679 4,201 $430.43
81002 372 358 $362.82
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 806 744 $355.35
G8482 Influenza immunization administered or previously received 918 856 $246.70
G8484 Influenza immunization was not administered, reason not given 1,020 939 $246.70
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 235 232 $237.89
69210 21 19 $217.32
G9903 Patient screened for tobacco use and identified as a tobacco non-user 985 915 $182.01
90656 667 663 $175.01
81025 74 72 $174.27
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 119 118 $172.25
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 3,528 3,041 $69.23
93000 141 138 $58.11
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 315 305 $55.70
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 101 100 $11.25
G8418 Bmi is documented below normal parameters and a follow-up plan is documented 258 243 $0.00
G9902 Patient screened for tobacco use and identified as a tobacco user 1,148 1,053 $0.00
J1885 Injection, ketorolac tromethamine, per 15 mg 43 40 $0.00
G9906 Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) 741 679 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 742 686 $0.00
90697 70 70 $0.00
G8432 Depression screening not documented, reason not given 35 34 $0.00
90686 251 244 $0.00
90733 13 13 $0.00
91301 34 34 $0.00
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 29 29 $0.00
87807 44 41 $0.00
90698 24 24 $0.00
91305 21 21 $0.00
G9716 Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason 12 12 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 19 18 $0.00
G0030 Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user 341 298 $0.00
G9905 Patient not screened for tobacco use 61 60 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 169 156 $0.00
90734 86 86 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 686 646 $0.00
91300 112 107 $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) 466 454 $0.00
94664 45 42 $0.00
90710 71 70 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 68 61 $0.00
G9900 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified 31 29 $0.00
97803 12 12 $0.00