Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › GA › ATLANTA › SOUTHSIDE MEDICAL CENTER, INC.

SOUTHSIDE MEDICAL CENTER, INC.

NPI: 1235123993 · ATLANTA, GA 30315 · Community Health Clinic/Center · NPI assigned 09/08/2005

$28.82M
Total Medicaid Paid
752,800
Total Claims
613,385
Beneficiaries
190
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKASSA, MASRESHA (CFO)
NPI Enumeration Date09/08/2005

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 103,651 $4.67M
2019 109,068 $4.98M
2020 80,836 $4.07M
2021 72,449 $3.65M
2022 84,750 $4.33M
2023 150,455 $3.91M
2024 151,591 $3.21M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 85,293 70,513 $8.19M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 75,339 63,223 $7.15M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 30,844 27,850 $2.82M
D0999 Unspecified diagnostic procedure, by report 29,751 21,216 $2.13M
H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) 47,714 2,009 $1.14M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 6,451 5,946 $725K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 6,147 5,982 $703K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 6,046 5,954 $684K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 5,221 5,114 $603K
D0150 Comprehensive oral evaluation - new or established patient 12,455 11,456 $580K
90460 Immunization administration through 18 years of age via any route, first or only component 17,987 17,412 $430K
D0140 Limited oral evaluation - problem focused 8,688 6,326 $402K
D0220 Intraoral - periapical first radiographic image 17,406 14,155 $221K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 2,430 2,233 $210K
D7140 Extraction, erupted tooth or exposed root 5,361 3,018 $206K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2,322 2,186 $203K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 2,085 1,937 $197K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 279 262 $185K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 1,766 1,623 $170K
D1120 Prophylaxis - child 5,991 5,415 $156K
D1110 Prophylaxis - adult 3,683 3,372 $137K
90837 Psychotherapy, 53 minutes with patient 1,772 977 $120K
99383 1,144 1,094 $119K
99384 1,007 960 $103K
D1206 Topical application of fluoride varnish 5,114 4,620 $101K
D0330 Panoramic radiographic image 2,424 1,853 $99K
99381 1,060 985 $96K
D1351 Sealant - per tooth 3,900 1,339 $80K
99215 Prolong outpt/office vis 889 739 $80K
99173 18,373 17,914 $65K
92551 16,374 15,995 $60K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 621 563 $54K
D0120 Periodic oral evaluation - established patient 1,309 1,152 $47K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 551 526 $46K
96110 Developmental screening, with scoring and documentation, per standardized instrument 3,961 3,753 $38K
99382 369 340 $35K
90832 Psychotherapy, 30 minutes with patient 1,091 736 $33K
S0621 Routine ophthalmological examination including refraction; established patient 258 257 $25K
T1003 Lpn/lvn services, up to 15 minutes 1,348 1,095 $22K
99050 968 901 $22K
D1208 Topical application of fluoride, excluding varnish 3,905 3,535 $20K
99385 238 214 $20K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 342 262 $17K
D0230 Intraoral - periapical each additional radiographic image 11,116 9,008 $17K
D0274 Bitewings - four radiographic images 5,511 4,865 $16K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 193 180 $16K
86008 70 63 $14K
90853 Group psychotherapy (other than of a multiple-family group) 716 223 $12K
90834 Psychotherapy, 45 minutes with patient 234 157 $12K
81025 13,917 13,006 $11K
D2391 Resin-based composite - one surface, posterior, primary or permanent 161 132 $10K
D0272 Bitewings - two radiographic images 2,490 2,219 $9K
D7111 100 73 $7K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 138 138 $7K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 178 113 $7K
90671 684 655 $7K
92340 Fitting of spectacles, except for aphakia; monofocal 501 484 $6K
90791 Psychiatric diagnostic evaluation 53 53 $6K
99078 117 77 $6K
0001A 160 155 $6K
90651 2,876 2,789 $6K
Q3014 Telehealth originating site facility fee 599 585 $6K
81002 28,921 23,041 $5K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 694 627 $5K
90792 Psychiatric diagnostic evaluation with medical services 64 49 $5K
90472 Immunization administration, each additional vaccine (list separately) 202 197 $5K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 635 598 $4K
99386 38 37 $4K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 513 496 $4K
99283 Emergency department visit for the evaluation and management, moderate severity 54 52 $3K
V2020 Frames, purchases 304 299 $3K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 75 51 $2K
96127 10,452 9,684 $2K
11721 2,029 1,799 $2K
90715 1,370 1,298 $2K
76801 475 453 $2K
0002A 58 56 $2K
T1002 Rn services, up to 15 minutes 108 81 $2K
99205 Prolong outpt/office vis 20 16 $2K
H0031 Mental health assessment, by non-physician 40 24 $2K
3078F 18,441 16,448 $2K
99429 983 807 $2K
0011A 52 42 $2K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 13 13 $1K
96161 706 633 $1K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 373 368 $1K
3079F 6,082 5,569 $1K
92283 86 84 $1K
99188 183 182 $1K
90686 1,889 1,792 $1K
59025 Fetal non-stress test 43 43 $1K
90670 3,691 3,509 $1K
J1050 Injection, medroxyprogesterone acetate, 1 mg 27 24 $1K
91300 376 347 $961.51
H0032 Mental health service plan development by non-physician 15 12 $905.65
90785 329 242 $888.09
92227 53 45 $863.08
0012A 26 25 $840.00
3074F 19,737 17,508 $829.86
90734 1,903 1,829 $689.50
3075F 2,118 1,967 $675.94
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 16,626 15,502 $665.51
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 184 181 $664.72
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 328 272 $629.60
V2025 Deluxe frame 32 32 $600.00
S0620 Routine ophthalmological examination including refraction; new patient 16 16 $598.00
82962 4,517 3,813 $592.25
20610 19 17 $569.30
36415 Collection of venous blood by venipuncture 162 150 $505.80
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 51 49 $434.16
90620 905 876 $418.22
0031A 25 17 $360.00
90674 55 55 $240.00
36410 17 17 $185.97
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 2,852 2,396 $183.06
90756 45 45 $170.00
91301 130 120 $160.17
A4267 Contraceptive supply, condom, male, each 153 141 $126.28
90656 33 28 $124.45
90723 2,681 2,584 $124.12
83655 214 210 $117.00
87210 398 388 $116.88
3077F 1,681 1,476 $91.41
85018 726 713 $85.22
3080F 1,302 1,177 $76.31
11055 14 13 $56.85
87420 52 46 $45.24
90633 2,482 2,330 $40.93
99402 66 60 $40.50
36416 183 180 $28.00
11056 54 53 $25.23
90647 2,510 2,403 $21.77
90700 412 392 $11.77
1160F 15,331 13,565 $10.00
92015 Determination of refractive state 13 12 $10.00
96160 243 224 $1.37
3008F 21,556 19,776 $0.08
2010F 30,255 26,425 $0.08
2022F 12 12 $0.01
90680 533 513 $0.00
2001F 24,375 21,380 $0.00
90716 558 513 $0.00
1126F 4,442 4,092 $0.00
1125F 1,531 1,375 $0.00
99350 Prolong home eval add 15m 49 42 $0.00
1220F 7,444 6,109 $0.00
99024 98 89 $0.00
1170F 65 56 $0.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 261 229 $0.00
90619 458 445 $0.00
87490 25 25 $0.00
90697 473 442 $0.00
93000 54 49 $0.00
1036F 13 12 $0.00
90696 541 529 $0.00
V2784 Lens, polycarbonate or equal, any index, per lens 13 13 $0.00
76830 Ultrasound, transvaginal 97 92 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 13 12 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 26 24 $0.00
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 110 110 $0.00
91303 29 22 $0.00
99495 13 13 $0.00
97802 42 41 $0.00
G8432 Depression screening not documented, reason not given 13 12 $0.00
90698 13 13 $0.00
91307 12 12 $0.00
87590 13 13 $0.00
90649 197 195 $0.00
90710 775 750 $0.00
1159F 16,003 13,489 $0.00
90681 551 524 $0.00
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 265 258 $0.00
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 961 912 $0.00
90707 489 449 $0.00
1100F 1,826 1,692 $0.00
G0470 Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit 14 13 $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) 233 222 $0.00
G0444 Annual depression screening, 5 to 15 minutes 70 66 $0.00
G9920 Screening performed and negative 46 46 $0.00
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 96 94 $0.00
90713 17 17 $0.00
20552 27 27 $0.00
85014 39 39 $0.00
82948 29 28 $0.00
G8484 Influenza immunization was not administered, reason not given 87 80 $0.00
83037 38 38 $0.00
D1203 29 15 $0.00
D4341 63 29 $0.00
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 14 13 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 13 12 $0.00