Medicaid Provider Spending

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

PROVIDENCE HEALTH & SERVICES MT

NPI: 1215222617 · MISSOULA, MT 59802 · Clinical Social Worker · NPI assigned 06/14/2011

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

Authorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more

$5.67M
Total Medicaid Paid
86,982
Total Claims
67,754
Beneficiaries
58
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialANDERSON, DONALD (ASSISTANT SECRETARY ENROLLMENTS)
Parent OrganizationPROVIDENCE HEALTH & SERVICES
NPI Enumeration Date06/14/2011

Related Entities

Other providers sharing the same authorized official: ANDERSON, DONALD

ProviderCityStateTotal Paid
PROVIDENCE HEALTH & SERVICES WASHINGTON ANCHORAGE AK $161.45M
KADLEC REGIONAL MEDICAL CENTER RICHLAND WA $151.60M
SWEDISH EDMONDS EDMONDS WA $30.06M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC EUREKA CA $28.68M
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA TORRANCE CA $27.29M
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA SAN PEDRO CA $24.26M
PROVIDENCE HEALTH & SERVICES - WASHINGTON TUKWILA WA $21.98M
SWEDISH HEALTH SERVICES SEATTLE WA $21.06M
PROVIDENCE HEALTH & SERVICES WASHINGTON KODIAK AK $11.39M
SWEDISH HEALTH SERVICES SEATTLE WA $11.08M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC FORTUNA CA $8.55M
COLLABRIA CARE NAPA CA $8.20M
PROVIDENCE HEALTH & SERVICES OREGON SEASIDE OR $8.01M
PROVIDENCE HEALTH & SERVICES- WASHINGTON SPOKANE WA $8.01M
HOSPICE OF LUBBOCK INC LUBBOCK TX $6.48M
PROVIDENCE SAINT JOHN'S HEALTH CENTER SANTA MONICA CA $5.52M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.55M
COLLABRIA CARE NAPA CA $4.05M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.01M
METHODIST HOSPITAL PLAINVIEW TEXAS PLAINVIEW TX $4.00M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 13,882 $821K
2019 14,204 $899K
2020 10,610 $703K
2021 15,224 $1.01M
2022 14,268 $930K
2023 13,104 $808K
2024 5,690 $500K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 23,429 20,928 $2.05M
99232 Subsequent hospital care, per day, moderate complexity 20,389 9,414 $1.15M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 13,910 12,712 $940K
90792 Psychiatric diagnostic evaluation with medical services 2,413 2,286 $352K
99239 Hospital discharge day management, more than 30 minutes 2,496 2,343 $238K
99223 Prolong inpt eval add15 m 1,023 946 $140K
99233 Prolong inpt eval add15 m 1,794 850 $135K
99215 Prolong outpt/office vis 785 744 $101K
99231 Subsequent hospital care, per day, straightforward or low complexity 1,750 973 $66K
99205 Prolong outpt/office vis 285 266 $45K
90832 Psychotherapy, 30 minutes with patient 1,030 570 $41K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 303 276 $40K
J0585 Injection, onabotulinumtoxina, 1 unit 220 118 $39K
90834 Psychotherapy, 45 minutes with patient 646 412 $35K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,264 1,215 $25K
36415 Collection of venous blood by venipuncture 6,570 5,988 $23K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 225 219 $19K
99443 310 257 $19K
90837 Psychotherapy, 53 minutes with patient 233 131 $16K
99310 Prolong nursin fac eval 15m 844 771 $15K
99309 Subsequent nursing facility care, per day, low to moderate complexity 1,053 894 $15K
99441 353 349 $14K
99222 Initial hospital care, per day, moderate complexity 152 141 $14K
95811 83 79 $14K
95251 508 448 $13K
99442 232 210 $11K
64405 106 106 $9K
95810 Polysomnography; sleep staging with 4 or more additional parameters 69 69 $9K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 79 78 $9K
95886 74 61 $9K
83036 Hemoglobin; glycosylated (A1C) 1,372 1,158 $8K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 141 135 $8K
90686 716 696 $6K
64615 120 117 $5K
90791 Psychiatric diagnostic evaluation 53 51 $5K
94729 321 313 $4K
99238 Hospital discharge day management, 30 minutes or less 70 64 $3K
94726 222 214 $3K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 65 57 $3K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 43 42 $3K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 70 67 $3K
95910 17 15 $3K
99308 Subsequent nursing facility care, per day, straightforward 273 215 $2K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 12 12 $2K
94060 166 156 $1K
99497 19 12 $802.53
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 19 17 $759.39
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) 16 13 $661.61
0124A 17 17 $520.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 30 14 $505.80
90682 12 12 $392.07
99356 28 27 $296.51
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 78 78 $244.20
94618 14 12 $149.46
90656 12 12 $127.36
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 14 14 $0.00
J3490 Unclassified drugs 100 95 $0.00
36416 334 265 $0.00