Medicaid Provider Spending

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

NPI: 1245278209 · DULUTH, MN 55805 · Mental Health Clinic/Center (Including Community Mental Health Center) · NPI assigned 06/03/2006

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

Authorized official BOREN, KEVIN controls 20+ related entities in our dataset. Read more

$51.60M
Total Medicaid Paid
1,169,523
Total Claims
914,669
Beneficiaries
261
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBOREN, KEVIN (VP OF FINANCE)
Parent OrganizationESSENTIA HEALTH
NPI Enumeration Date06/03/2006

Related Entities

Other providers sharing the same authorized official: BOREN, KEVIN

ProviderCityStateTotal Paid
ST. JOSEPH'S MEDICAL CENTER BRAINERD MN $41.35M
SMDC MEDICAL CENTER DULUTH MN $35.51M
ST MARYS MEDICAL CENTER DULUTH MN $20.98M
ST. MARY'S HOSPITAL OF SUPERIOR SUPERIOR WI $13.36M
ST JOSEPH'S MEDICAL CENTER BAXTER MN $7.23M
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM DULUTH MN $4.97M
DEER RIVER HEALTHCARE CENTER, INC. DEER RIVER MN $4.57M
ST. MARY'S MEDICAL CENTER DULUTH MN $3.66M
ST. JOSEPH'S MEDICAL CENTER BRAINERD MN $3.25M
THE DULUTH CLINIC, LTD VIRGINIA MN $2.82M
THE DULUTH CLINIC, LTD DULUTH MN $2.66M
NORTHERN PINES MEDICAL CENTER AURORA MN $1.72M
ST. MARY'S HOSPITAL OF SUPERIOR SUPERIOR WI $1.65M
POLINSKY MEDICAL REHABILITATION CENTER DULUTH MN $1.61M
PINE MEDICAL CENTER SANDSTONE MN $1.32M
THE DULUTH CLINIC, LTD HERMANTOWN MN $1.30M
THE DULUTH CLINIC LTD GRAND RAPIDS MN $1.18M
THE DULUTH CLINIC, LTD DULUTH MN $1.13M
THE DULUTH CLINIC, LTD ASHLAND WI $1.07M
ST MARY'S HOSPITAL OF SUPERIOR SPOONER WI $1.05M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 194,852 $2.95M
2019 191,853 $9.26M
2020 172,293 $8.98M
2021 193,491 $10.22M
2022 169,383 $9.02M
2023 147,764 $7.06M
2024 99,887 $4.11M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G9002 Coordinated care fee, maintenance rate 74,210 69,884 $13.74M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 120,626 105,037 $6.38M
99233 Prolong inpt eval add15 m 75,928 18,607 $4.14M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 109,903 97,547 $3.58M
99232 Subsequent hospital care, per day, moderate complexity 69,843 17,596 $2.64M
99215 Prolong outpt/office vis 22,905 20,970 $1.79M
99223 Prolong inpt eval add15 m 16,885 13,973 $1.70M
88305 Level IV - Surgical pathology, gross and microscopic examination 39,267 28,228 $1.54M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 8,554 2,374 $950K
99239 Hospital discharge day management, more than 30 minutes 15,386 14,039 $930K
74177 Computed tomography, abdomen and pelvis; with contrast material 18,136 16,604 $847K
99244 Office or other outpatient consultation, moderate to high complexity 9,069 8,643 $782K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 10,450 9,930 $692K
90834 Psychotherapy, 45 minutes with patient 11,643 6,755 $610K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 14,086 13,427 $563K
99243 8,929 8,542 $487K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 12,392 11,459 $447K
99309 Subsequent nursing facility care, per day, low to moderate complexity 9,418 6,154 $441K
70450 Computed tomography, head or brain; without contrast material 20,462 18,182 $441K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 91,651 72,843 $415K
99310 Prolong nursin fac eval 15m 5,456 4,293 $406K
X5622 7,614 6,859 $400K
S0302 Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) 11,484 11,014 $370K
99231 Subsequent hospital care, per day, straightforward or low complexity 12,950 4,291 $310K
90460 Immunization administration through 18 years of age via any route, first or only component 12,840 12,357 $286K
90792 Psychiatric diagnostic evaluation with medical services 1,590 1,438 $253K
71045 Radiologic examination, chest; single view 55,144 38,878 $252K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 5,514 5,209 $249K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 13,850 12,093 $226K
77067 Screening mammography, bilateral, including computer-aided detection 10,360 10,128 $209K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 4,609 4,498 $206K
99336 1,991 1,566 $197K
99254 1,862 1,516 $197K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 5,359 4,927 $187K
99205 Prolong outpt/office vis 1,677 1,602 $183K
71046 Radiologic examination, chest; 2 views 30,642 28,523 $177K
99238 Hospital discharge day management, 30 minutes or less 4,048 3,858 $169K
71275 Computed tomographic angiography, chest, with contrast material 3,671 3,423 $169K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 2,802 2,720 $161K
99222 Initial hospital care, per day, moderate complexity 2,512 2,130 $143K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 3,234 3,105 $142K
92015 Determination of refractive state 11,735 11,344 $129K
99443 2,419 2,222 $119K
99335 1,886 1,247 $118K
72125 Computed tomography, cervical spine; without contrast material 4,159 3,847 $114K
99308 Subsequent nursing facility care, per day, straightforward 4,011 2,828 $114K
88307 1,435 1,296 $111K
90461 5,999 5,768 $105K
99255 687 594 $102K
99253 1,330 1,101 $100K
74176 Computed tomography, abdomen and pelvis; without contrast material 2,363 2,185 $99K
99245 733 699 $82K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,407 1,347 $82K
90839 1,047 941 $82K
90961 849 820 $71K
71260 Computed tomography, thorax, diagnostic; with contrast material 2,141 2,012 $65K
77063 Screening digital breast tomosynthesis, bilateral 3,457 3,388 $65K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 837 656 $64K
76705 Ultrasound, abdominal, real time with image documentation; limited 3,904 3,666 $60K
92551 8,866 8,473 $56K
88342 1,928 1,747 $56K
99417 Prolong home eval add 15m 1,315 1,254 $56K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,082 791 $53K
99349 614 506 $52K
99220 572 544 $51K
99242 1,304 1,261 $49K
64615 822 769 $48K
99442 1,470 1,380 $48K
99479 Subsequent intensive care, per day, very low birth weight infant 646 152 $47K
20610 1,787 1,439 $46K
90837 Psychotherapy, 53 minutes with patient 469 309 $43K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 610 506 $43K
70551 Magnetic resonance imaging, brain; without contrast material 1,096 931 $43K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 937 874 $42K
73630 8,415 7,270 $41K
95251 1,717 1,604 $36K
99188 3,928 3,751 $35K
92060 1,606 1,289 $34K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 1,371 1,319 $33K
76830 Ultrasound, transvaginal 1,800 1,679 $33K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,602 2,518 $29K
73610 5,644 5,069 $28K
90791 Psychiatric diagnostic evaluation 288 257 $25K
96127 7,319 7,143 $25K
74018 5,270 4,214 $24K
90832 Psychotherapy, 30 minutes with patient 605 398 $24K
96133 149 144 $24K
93294 1,442 1,379 $24K
73030 4,584 4,070 $24K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 542 392 $22K
73562 4,116 3,608 $21K
73130 4,298 3,722 $21K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 1,208 1,140 $21K
99292 266 137 $21K
99221 674 586 $20K
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care 13 13 $19K
96116 332 314 $19K
88141 821 797 $18K
99217 531 505 $18K
73502 2,609 2,377 $15K
96110 Developmental screening, with scoring and documentation, per standardized instrument 2,418 2,289 $15K
45380 Colonoscopy, flexible; with biopsy, single or multiple 224 214 $15K
93971 1,268 1,176 $15K
96132 159 154 $14K
73110 2,916 2,531 $14K
88304 1,187 1,126 $14K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 93 91 $13K
99460 288 280 $13K
72100 2,130 2,025 $12K
99348 236 182 $11K
99173 5,470 5,225 $11K
99350 Prolong home eval add 15m 105 93 $11K
11721 690 662 $11K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 394 245 $10K
76881 616 464 $10K
99152 1,659 1,496 $10K
70486 444 416 $9K
71250 331 322 $9K
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 96 64 $9K
99480 Subsequent intensive care, per day, low birth weight infant 147 26 $9K
84165 688 639 $9K
99177 1,850 1,743 $8K
96121 159 154 $8K
93295 330 327 $8K
76770 389 361 $7K
70496 167 157 $7K
36415 Collection of venous blood by venipuncture 3,013 2,529 $7K
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) 3,446 3,213 $7K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 109 95 $7K
70498 155 147 $7K
77080 803 771 $6K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 148 139 $6K
88341 51 50 $6K
94060 710 635 $6K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 122 85 $6K
92134 454 353 $6K
72141 124 100 $6K
99306 Prolong nursin fac eval 15m 57 55 $6K
99337 40 38 $6K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 100 98 $5K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 126 117 $5K
G0426 Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth 81 72 $4K
93325 1,417 1,250 $4K
96040 113 107 $4K
93244 216 213 $4K
71271 111 109 $4K
92587 256 201 $4K
93018 490 471 $4K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 41 38 $4K
90962 26 26 $3K
90935 Hemodialysis procedure with single evaluation by a physician 136 67 $3K
76642 190 161 $3K
93320 190 153 $3K
72040 527 506 $3K
73590 722 619 $3K
73564 528 439 $3K
99347 100 73 $3K
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 316 308 $3K
73140 807 713 $3K
92340 Fitting of spectacles, except for aphakia; monofocal 200 198 $3K
93280 154 127 $3K
93016 251 250 $3K
76801 125 108 $3K
72170 483 450 $2K
88312 73 67 $2K
90840 60 49 $2K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 12 12 $2K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 1,003 921 $2K
99605 42 41 $2K
90662 63 63 $2K
99307 69 61 $2K
99441 116 114 $2K
G0408 Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth 48 29 $2K
94726 258 250 $2K
20611 48 41 $2K
90686 6,682 6,462 $2K
74019 271 253 $2K
67028 Intravitreal injection of a pharmacologic agent 27 25 $2K
62323 26 26 $1K
94729 292 284 $1K
93296 102 101 $1K
V5266 Battery for use in hearing device 110 105 $1K
90472 Immunization administration, each additional vaccine (list separately) 97 94 $1K
95886 38 38 $1K
29075 46 39 $1K
G0407 Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth 67 14 $1K
93970 85 83 $1K
76536 60 58 $1K
92567 88 76 $1K
73221 19 12 $1K
80053 Comprehensive metabolic panel 88 78 $984.72
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 14 13 $980.42
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 37 30 $848.95
54150 57 54 $837.72
76819 Fetal biophysical profile; without non-stress testing 29 15 $836.66
99344 16 14 $807.67
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 30 24 $774.78
84443 Thyroid stimulating hormone (TSH) 44 42 $749.82
86334 62 62 $732.09
64642 13 12 $723.93
73560 198 161 $643.79
70491 15 12 $633.52
92133 45 41 $625.14
G0008 Administration of influenza virus vaccine 64 64 $624.40
77065 Tomosynthesis, mammo 13 12 $611.20
73090 157 121 $604.48
95874 52 39 $565.59
64405 16 13 $564.16
88112 27 24 $552.57
85025 Blood count; complete (CBC), automated, and automated differential WBC count 296 108 $542.08
90656 195 193 $527.30
99226 13 12 $520.09
91200 91 81 $519.28
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) 39 37 $495.92
73080 96 89 $453.78
85027 62 55 $411.60
72132 12 12 $403.05
73552 63 55 $390.72
99464 12 12 $343.90
99462 24 13 $332.40
64450 15 13 $326.33
92136 12 12 $302.35
73100 47 42 $295.55
92083 15 13 $284.43
72070 41 41 $260.23
0298T 14 12 $252.84
11900 12 12 $251.46
90677 80 77 $225.71
93298 12 12 $223.65
93227 37 37 $213.10
92025 12 12 $197.00
93308 14 12 $193.00
76882 12 12 $159.78
80061 Lipid panel 12 12 $156.09
72082 12 12 $136.55
90716 311 297 $135.86
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 13 12 $118.35
96161 84 78 $116.64
77001 13 12 $110.27
90670 2,781 2,705 $89.67
76937 28 24 $78.75
73000 13 12 $78.14
90647 1,998 1,940 $52.62
90723 1,953 1,894 $40.92
90734 209 193 $30.01
90685 663 639 $24.59
90651 483 463 $18.46
90672 49 49 $15.30
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 19 17 $14.72
90680 1,662 1,623 $10.80
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 8,755 6,269 $0.84
90633 1,255 1,193 $0.55
90696 92 92 $0.13
90710 169 165 $0.13
90707 201 191 $0.02
90870 35 12 $0.00
90688 61 60 $0.00
90700 145 138 $0.00
H1000 Prenatal care, at-risk assessment 14 12 $0.00
90715 62 59 $0.00
91300 15 13 $0.00