Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Clinic

The Duluth Clinic, LTD

The Duluth Clinic, LTD was paid $51.60M by Medicaid between Jan 2018 and Dec 2024, across 261 billing codes. Its largest line is G9002, Coordinated care fee, maintenance rate — 27% of everything it billed.

33Billing provider infoTHE DULUTH CLINIC, LTD
DULUTH, MN 55805
33aNPI1245278209assigned 06/03/2006
33bProvider typeMental Health Clinic/Center (Including Community Mental Health Center)
28Total paid$51.60M
24GClaims1,169,523
24DCodes billed261
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Mental Health Clinic/Center (Including Community Mental Health Center) providers in Minnesota

Rank by total paid#2 of 160
Median peer was paid$193K
This provider vs. median267×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official BOREN, KEVIN controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$500K$1.0M2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
2018194,852$2.95M
2019191,853$9.26M
2020172,293$8.98M
2021193,491$10.22M
2022169,383$9.02M
2023147,764$7.06M
2024incomplete99,887$4.11M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
G9002 Coordinated care fee, maintenance rate 27% 74,210 69,884 $13.74M
99214 Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 12% 120,626 105,037 $6.38M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 8.0% 75,928 18,607 $4.14M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6.9% 109,903 97,547 $3.58M
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 5.1% 69,843 17,596 $2.64M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 3.5% 22,905 20,970 $1.79M
99223 Prolong inpt eval add15 m 3.3% 16,885 13,973 $1.70M
88305 Level IV - Surgical pathology, gross and microscopic examination 3.0% 39,267 28,228 $1.54M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 1.8% 8,554 2,374 $950K
99239 Hospital discharge day management, more than 30 minutes 1.8% 15,386 14,039 $930K
74177 Computed tomography, abdomen and pelvis; with contrast material 1.6% 18,136 16,604 $847K
99244 Office or other outpatient consultation, moderate to high complexity 1.5% 9,069 8,643 $782K
249 more codes
99204 Doctor's office visit, new patient (more involved) 1.3% 10,450 $692K
90834 Psychotherapy session, about 45 minutes 1.2% 11,643 $610K
99203 Doctor's office visit, new patient (routine) 1.1% 14,086 $563K
99243 <1% 8,929 $487K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 12,392 $447K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 9,418 $441K
70450 Computed tomography, head or brain; without contrast material <1% 20,462 $441K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 91,651 $415K
99310 Prolong nursin fac eval 15m <1% 5,456 $406K
X5622 <1% 7,614 $400K
S0302 Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) <1% 11,484 $370K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 12,950 $310K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 12,840 $286K
90792 Psychiatric diagnostic evaluation with medical services <1% 1,590 $253K
71045 Radiologic examination, chest; single view <1% 55,144 $252K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 5,514 $249K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 13,850 $226K
77067 Screening mammography, bilateral, including computer-aided detection <1% 10,360 $209K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 4,609 $206K
99336 <1% 1,991 $197K
99254 <1% 1,862 $197K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 5,359 $187K
99205 Prolong outpt/office vis <1% 1,677 $183K
71046 Radiologic examination, chest; 2 views <1% 30,642 $177K
99238 Hospital discharge day management, 30 minutes or less <1% 4,048 $169K
71275 Computed tomographic angiography, chest, with contrast material <1% 3,671 $169K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 2,802 $161K
99222 Initial hospital care, per day, moderate complexity <1% 2,512 $143K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 3,234 $142K
92015 Determination of refractive state <1% 11,735 $129K
99443 <1% 2,419 $119K
99335 <1% 1,886 $118K
72125 Computed tomography, cervical spine; without contrast material <1% 4,159 $114K
99308 Subsequent nursing facility care, per day, straightforward <1% 4,011 $114K
88307 <1% 1,435 $111K
90461 <1% 5,999 $105K
99255 <1% 687 $102K
99253 <1% 1,330 $100K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 2,363 $99K
99245 <1% 733 $82K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 1,407 $82K
90839 <1% 1,047 $82K
90961 <1% 849 $71K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 2,141 $65K
77063 Screening digital breast tomosynthesis, bilateral <1% 3,457 $65K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 837 $64K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 3,904 $60K
92551 <1% 8,866 $56K
88342 <1% 1,928 $56K
99417 Prolong home eval add 15m <1% 1,315 $56K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 1,082 $53K
99349 <1% 614 $52K
99220 <1% 572 $51K
99242 <1% 1,304 $49K
64615 <1% 822 $48K
99442 <1% 1,470 $48K
99479 Subsequent intensive care, per day, very low birth weight infant <1% 646 $47K
20610 <1% 1,787 $46K
90837 Psychotherapy session, about an hour <1% 469 $43K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 610 $43K
70551 Magnetic resonance imaging, brain; without contrast material <1% 1,096 $43K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 937 $42K
73630 <1% 8,415 $41K
95251 <1% 1,717 $36K
99188 <1% 3,928 $35K
92060 <1% 1,606 $34K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 1,371 $33K
76830 Ultrasound, transvaginal <1% 1,800 $33K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 2,602 $29K
73610 <1% 5,644 $28K
90791 Psychiatric diagnostic evaluation <1% 288 $25K
96127 <1% 7,319 $25K
74018 <1% 5,270 $24K
90832 Psychotherapy session, about 30 minutes <1% 605 $24K
96133 <1% 149 $24K
93294 <1% 1,442 $24K
73030 <1% 4,584 $24K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 542 $22K
73562 <1% 4,116 $21K
73130 <1% 4,298 $21K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 1,208 $21K
99292 <1% 266 $21K
99221 <1% 674 $20K
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care <1% 13 $19K
96116 <1% 332 $19K
88141 <1% 821 $18K
99217 <1% 531 $18K
73502 <1% 2,609 $15K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 2,418 $15K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 224 $15K
93971 <1% 1,268 $15K
96132 <1% 159 $14K
73110 <1% 2,916 $14K
88304 <1% 1,187 $14K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 93 $13K
99460 <1% 288 $13K
72100 <1% 2,130 $12K
99348 <1% 236 $11K
99173 <1% 5,470 $11K
99350 Prolong home eval add 15m <1% 105 $11K
11721 <1% 690 $11K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 394 $10K
76881 <1% 616 $10K
99152 <1% 1,659 $10K
70486 <1% 444 $9K
71250 <1% 331 $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 <1% 96 $9K
99480 Subsequent intensive care, per day, low birth weight infant <1% 147 $9K
84165 <1% 688 $9K
99177 <1% 1,850 $8K
96121 <1% 159 $8K
93295 <1% 330 $8K
76770 <1% 389 $7K
70496 <1% 167 $7K
36415 Collection of venous blood by venipuncture <1% 3,013 $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) <1% 3,446 $7K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 109 $7K
70498 <1% 155 $7K
77080 <1% 803 $6K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 148 $6K
88341 <1% 51 $6K
94060 <1% 710 $6K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study <1% 122 $6K
92134 <1% 454 $6K
72141 <1% 124 $6K
99306 Prolong nursin fac eval 15m <1% 57 $6K
99337 <1% 40 $6K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 100 $5K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 126 $5K
G0426 Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth <1% 81 $4K
93325 <1% 1,417 $4K
96040 <1% 113 $4K
93244 <1% 216 $4K
71271 <1% 111 $4K
92587 <1% 256 $4K
93018 <1% 490 $4K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits <1% 41 $4K
90962 <1% 26 $3K
90935 Hemodialysis procedure with single evaluation by a physician <1% 136 $3K
76642 <1% 190 $3K
93320 <1% 190 $3K
72040 <1% 527 $3K
73590 <1% 722 $3K
73564 <1% 528 $3K
99347 <1% 100 $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 <1% 316 $3K
73140 <1% 807 $3K
92340 Fitting of spectacles, except for aphakia; monofocal <1% 200 $3K
93280 <1% 154 $3K
93016 <1% 251 $3K
76801 <1% 125 $3K
72170 <1% 483 $2K
88312 <1% 73 $2K
90840 <1% 60 $2K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 12 $2K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 1,003 $2K
99605 <1% 42 $2K
90662 <1% 63 $2K
99307 <1% 69 $2K
99441 <1% 116 $2K
G0408 Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth <1% 48 $2K
94726 <1% 258 $2K
20611 <1% 48 $2K
90686 <1% 6,682 $2K
74019 <1% 271 $2K
67028 Intravitreal injection of a pharmacologic agent <1% 27 $2K
62323 <1% 26 $1K
94729 <1% 292 $1K
93296 <1% 102 $1K
V5266 Battery for use in hearing device <1% 110 $1K
90472 Immunization administration, each additional vaccine (list separately) <1% 97 $1K
95886 <1% 38 $1K
29075 <1% 46 $1K
G0407 Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth <1% 67 $1K
93970 <1% 85 $1K
76536 <1% 60 $1K
92567 <1% 88 $1K
73221 <1% 19 $1K
80053 Comprehensive metabolic panel <1% 88 $984.72
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 14 $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 <1% 37 $848.95
54150 <1% 57 $837.72
76819 Fetal biophysical profile; without non-stress testing <1% 29 $836.66
99344 <1% 16 $807.67
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 30 $774.78
84443 Thyroid stimulating hormone (TSH) <1% 44 $749.82
86334 <1% 62 $732.09
64642 <1% 13 $723.93
73560 <1% 198 $643.79
70491 <1% 15 $633.52
92133 <1% 45 $625.14
G0008 Administration of influenza virus vaccine <1% 64 $624.40
77065 Tomosynthesis, mammo <1% 13 $611.20
73090 <1% 157 $604.48
95874 <1% 52 $565.59
64405 <1% 16 $564.16
88112 <1% 27 $552.57
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 296 $542.08
90656 <1% 195 $527.30
99226 <1% 13 $520.09
91200 <1% 91 $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) <1% 39 $495.92
73080 <1% 96 $453.78
85027 <1% 62 $411.60
72132 <1% 12 $403.05
73552 <1% 63 $390.72
99464 <1% 12 $343.90
99462 <1% 24 $332.40
64450 <1% 15 $326.33
92136 <1% 12 $302.35
73100 <1% 47 $295.55
92083 <1% 15 $284.43
72070 <1% 41 $260.23
0298T <1% 14 $252.84
11900 <1% 12 $251.46
90677 <1% 80 $225.71
93298 <1% 12 $223.65
93227 <1% 37 $213.10
92025 <1% 12 $197.00
93308 <1% 14 $193.00
76882 <1% 12 $159.78
80061 Lipid panel <1% 12 $156.09
72082 <1% 12 $136.55
90716 <1% 311 $135.86
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 13 $118.35
96161 <1% 84 $116.64
77001 <1% 13 $110.27
90670 <1% 2,781 $89.67
76937 <1% 28 $78.75
73000 <1% 13 $78.14
90647 <1% 1,998 $52.62
90723 <1% 1,953 $40.92
90734 <1% 209 $30.01
90685 <1% 663 $24.59
90651 <1% 483 $18.46
90672 <1% 49 $15.30
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 19 $14.72
90680 <1% 1,662 $10.80
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program <1% 8,755 $0.84
90633 <1% 1,255 $0.55
90696 <1% 92 $0.13
90710 <1% 169 $0.13
90707 <1% 201 $0.02
90870 0% 35 $0.00
90688 0% 61 $0.00
90700 0% 145 $0.00
H1000 Prenatal care, at-risk assessment 0% 14 $0.00
90715 0% 62 $0.00
91300 0% 15 $0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialBOREN, KEVIN (VP OF FINANCE)
Parent organizationESSENTIA HEALTH
Same official

Other billing entities under BOREN, KEVIN

Full network →
ProviderLocationPaid
ST. Joseph's Medical CenterBrainerd, MN$41.35M
SMDC Medical CenterDuluth, MN$35.51M
ST Marys Medical CenterDuluth, MN$20.98M
ST. Mary's Hospital of SuperiorSuperior, WI$13.36M
ST Joseph's Medical CenterBaxter, MN$7.23M
ST. Mary's Duluth Clinic Health SystemDuluth, MN$4.97M
Deer River Healthcare Center, INC.Deer River, MN$4.57M
ST. Mary's Medical CenterDuluth, MN$3.66M
ST. Joseph's Medical CenterBrainerd, MN$3.25M
The Duluth Clinic, LTDVirginia, MN$2.82M
The Duluth Clinic, LTDDuluth, MN$2.66M
Northern Pines Medical CenterAurora, MN$1.72M
ST. Mary's Hospital of SuperiorSuperior, WI$1.65M
Polinsky Medical Rehabilitation CenterDuluth, MN$1.61M
Pine Medical CenterSandstone, MN$1.32M
The Duluth Clinic, LTDHermantown, MN$1.30M
The Duluth Clinic LTDGrand Rapids, MN$1.18M
The Duluth Clinic, LTDDuluth, MN$1.13M
The Duluth Clinic, LTDAshland, WI$1.07M
ST Mary's Hospital of SuperiorSpooner, WI$1.05M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.