Medicaid Provider Spending

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

CHILDREN'S COMMUNITY CARE

NPI: 1255349668 · BLAIRSVILLE, PA 15717 · Pediatrics Physician · NPI assigned 08/03/2006

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

Authorized official MARTINEZ, LORI controls 20+ related entities in our dataset. Read more

$113K
Total Medicaid Paid
2,237
Total Claims
2,097
Beneficiaries
13
Codes Billed
2022-07
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMARTINEZ, LORI (EXECUTIVE ADMINISTRATOR III)
NPI Enumeration Date08/03/2006

Related Entities

Other providers sharing the same authorized official: MARTINEZ, LORI

ProviderCityStateTotal Paid
CHILDREN'S COMMUNITY CARE WEXFORD PA $5.17M
CHILDREN'S COMMUNITY CARE SEWICKLEY PA $3.28M
CHILDREN'S COMMUNITY CARE UNIONTOWN PA $1.02M
CHILDREN'S COMMUNITY CARE PITTSBURGH PA $898K
CHILDEN'S COMMUNITY CARE NEW CASTLE PA $646K
CHILDREN'S COMMUNITY CARE MONONGAHELA PA $628K
CHILDREN'S COMMUNITY CARE ERIE PA $580K
CHILDEN'S COMMUNITY CARE PITTSBURGH PA $535K
CHILDEN'S COMMUNITY CARE HUMMELSTOWN PA $522K
CHILDREN'S COMMUNITY CARE YORK PA $500K
CHILDREN'S COMMUNITY CARE HUNTINGDON PA $470K
CHILDREN'S COMMUNITY CARE WEXFORD PA $467K
CHILDEN'S COMMUNITY CARE CAMP HILL PA $438K
CHILDREN'S COMMUNITY CARE PITTSBURGH PA $414K
CHILDREN'S COMMUNITY CARE NEW CASTLE PA $394K
CHILDEN'S COMMUNITY CARE HERMITAGE PA $276K
CHILDREN'S COMMUNITY CARE NORTH HUNTINGDON PA $252K
CHILDREN'S COMMUNITY CARE NATRONA HEIGHTS PA $207K
CHILDREN'S COMMUNITY CARE WHITE OAK PA $181K
CHILDEN'S COMMUNITY CARE GROVE CITY PA $177K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 200 $15K
2023 967 $52K
2024 1,070 $45K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 810 742 $77K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 436 409 $26K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 49 49 $5K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 26 26 $3K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 13 13 $1K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 68 66 $718.80
96127 112 110 $3.35
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) 166 154 $0.00
G9920 Screening performed and negative 240 220 $0.00
99177 25 24 $0.00
96160 113 111 $0.00
92551 109 106 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 70 67 $0.00