Medicaid Provider Spending

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

PRIMA CARE, PC

NPI: 1265422596 · FALL RIVER, MA 02721 · Ergonomics Occupational Therapist · NPI assigned 10/27/2005

$32.39M
Total Medicaid Paid
1,599,256
Total Claims
1,362,860
Beneficiaries
360
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGOMES, LAUREN (CREDENTIALING SPECIALIST)
NPI Enumeration Date10/27/2005

Related Entities

Other providers sharing the same authorized official: GOMES, LAUREN

ProviderCityStateTotal Paid
MODERN FAMILY CHIROPRACTIC, PLLC STERLING HEIGHTS MI $17K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 255,886 $5.28M
2019 251,400 $4.96M
2020 191,024 $4.21M
2021 238,773 $5.02M
2022 233,849 $5.39M
2023 225,404 $4.21M
2024 202,920 $3.32M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 183,903 172,319 $7.07M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 127,946 120,716 $4.00M
99233 Prolong inpt eval add15 m 82,782 36,574 $2.52M
99223 Prolong inpt eval add15 m 28,589 27,871 $1.92M
99215 Prolong outpt/office vis 19,930 19,079 $920K
99232 Subsequent hospital care, per day, moderate complexity 43,652 16,990 $887K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 38,922 12,307 $795K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 17,451 14,993 $745K
77067 Screening mammography, bilateral, including computer-aided detection 13,421 9,179 $601K
99239 Hospital discharge day management, more than 30 minutes 16,630 16,073 $549K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 6,503 6,461 $545K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 9,174 9,099 $491K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 4,613 4,553 $446K
95180 3,300 1,184 $442K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 4,159 4,141 $325K
71250 5,379 3,822 $256K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 7,514 7,474 $250K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials 1,527 1,515 $241K
98941 Chiropractic manipulative treatment; spinal, 3-4 regions 10,787 6,417 $239K
88305 Level IV - Surgical pathology, gross and microscopic examination 4,369 4,321 $225K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 2,631 1,243 $224K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 14,460 14,307 $224K
92340 Fitting of spectacles, except for aphakia; monofocal 8,116 6,248 $220K
76700 Ultrasound, abdominal, real time with image documentation; complete 5,457 3,685 $216K
J0897 Injection, denosumab, 1 mg 823 781 $205K
77063 Screening digital breast tomosynthesis, bilateral 13,139 8,945 $201K
80050 General health panel 11,745 11,629 $196K
99309 Subsequent nursing facility care, per day, low to moderate complexity 19,575 11,916 $187K
99308 Subsequent nursing facility care, per day, straightforward 25,515 15,191 $179K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,805 1,422 $175K
99205 Prolong outpt/office vis 1,746 1,730 $167K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 8,133 7,797 $163K
71046 Radiologic examination, chest; 2 views 14,993 10,230 $151K
83036 Hemoglobin; glycosylated (A1C) 35,855 35,270 $150K
99222 Initial hospital care, per day, moderate complexity 3,267 3,159 $150K
95810 Polysomnography; sleep staging with 4 or more additional parameters 783 516 $147K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 9,339 8,667 $146K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 959 856 $138K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 851 824 $128K
76536 3,359 2,307 $124K
92015 Determination of refractive state 9,712 9,696 $121K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 761 747 $116K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 43,114 41,600 $114K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 2,100 2,093 $111K
00812 1,512 1,492 $111K
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 2,001 1,712 $105K
93000 13,265 12,990 $105K
84443 Thyroid stimulating hormone (TSH) 22,837 22,522 $104K
74177 Computed tomography, abdomen and pelvis; with contrast material 1,043 693 $101K
45380 Colonoscopy, flexible; with biopsy, single or multiple 631 625 $94K
97162 2,596 2,586 $92K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 1,245 1,243 $92K
94150 9,066 3,235 $89K
99349 2,680 2,350 $81K
94060 4,368 3,014 $79K
92341 2,154 2,083 $74K
00731 891 887 $73K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 3,964 1,950 $69K
76642 2,172 1,294 $65K
11056 3,427 3,370 $65K
99497 6,669 6,387 $64K
73630 4,660 2,865 $62K
99220 814 802 $59K
99490 Ccm add 20min 6,892 6,852 $59K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,536 1,528 $57K
H2015 Comprehensive community support services, per 15 minutes 551 488 $57K
82607 7,952 7,855 $56K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 4,751 3,922 $56K
93458 566 547 $55K
11721 4,886 4,820 $55K
98940 3,626 2,081 $55K
73560 4,094 2,414 $45K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 4,976 1,880 $45K
93922 2,370 1,545 $45K
77080 4,852 3,621 $45K
95800 803 447 $44K
ATP03 6,963 6,941 $44K
99238 Hospital discharge day management, 30 minutes or less 1,787 1,748 $43K
80061 Lipid panel 54,571 53,988 $42K
83013 870 863 $40K
20610 1,720 1,530 $39K
92557 2,308 2,228 $38K
T1502 Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit 589 178 $37K
93976 756 475 $36K
94729 2,169 1,544 $36K
74176 Computed tomography, abdomen and pelvis; without contrast material 625 417 $36K
72100 2,925 1,877 $36K
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 2,001 1,713 $36K
73562 2,509 1,460 $35K
99443 1,554 1,471 $33K
ATP18 8,084 8,063 $33K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 527 520 $33K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 838 500 $32K
91200 2,684 1,941 $32K
99442 2,572 2,348 $32K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,813 1,795 $31K
82728 5,177 5,081 $30K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 823 808 $29K
84480 4,750 4,700 $29K
95024 359 356 $28K
ATP14 6,115 5,976 $28K
73030 2,694 1,643 $28K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 979 967 $27K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 979 968 $27K
95117 4,223 3,570 $26K
93015 833 821 $25K
94726 1,548 1,088 $25K
A4222 Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) 1,043 1,031 $25K
ATP15 5,129 4,973 $25K
00811 271 269 $25K
80053 Comprehensive metabolic panel 34,575 33,776 $24K
71271 450 325 $24K
97161 623 622 $24K
73130 1,520 902 $24K
99407 948 912 $23K
99441 3,495 3,168 $23K
76981 713 478 $23K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 550 547 $22K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 1,159 1,116 $22K
36415 Collection of venous blood by venipuncture 103,696 96,631 $22K
73502 1,807 1,170 $22K
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) 10,583 9,894 $21K
77081 3,239 2,408 $21K
84439 4,741 4,679 $21K
A0429 Ambulance service, basic life support, emergency transport (bls-emergency) 84 83 $20K
74019 1,780 1,208 $20K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 350 345 $20K
99310 Prolong nursin fac eval 15m 766 527 $20K
ATP17 7,429 7,416 $20K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 2,030 973 $20K
70450 Computed tomography, head or brain; without contrast material 553 375 $20K
84436 6,218 6,153 $20K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 344 343 $20K
76705 Ultrasound, abdominal, real time with image documentation; limited 715 480 $20K
83550 5,285 5,191 $20K
70551 Magnetic resonance imaging, brain; without contrast material 512 508 $19K
76830 Ultrasound, transvaginal 457 273 $19K
93975 236 157 $19K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 479 470 $18K
93971 558 329 $18K
84479 5,873 5,814 $18K
83540 6,505 6,351 $18K
11720 2,143 2,097 $18K
11057 1,051 1,042 $17K
81001 10,908 10,588 $17K
99231 Subsequent hospital care, per day, straightforward or low complexity 1,480 805 $17K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 4,724 4,468 $17K
92504 1,359 1,234 $17K
J2357 Injection, omalizumab, 5 mg 661 612 $16K
92567 2,385 2,309 $16K
93298 1,263 1,216 $16K
ATP04 2,381 2,380 $16K
E0431 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing 1,209 1,191 $15K
99072 20,764 18,056 $15K
90686 1,529 1,516 $15K
00813 170 167 $15K
97530 Therapeutic activities, direct patient contact, each 15 minutes 1,124 465 $15K
31231 134 132 $14K
95816 187 144 $14K
82043 6,974 6,886 $14K
99406 7,224 6,386 $14K
77065 Tomosynthesis, mammo 385 233 $14K
73610 1,185 706 $13K
83970 885 859 $13K
80305 2,127 1,769 $13K
J2704 Injection, propofol, 10 mg 5,374 5,246 $12K
43235 235 234 $12K
95806 175 104 $12K
99305 556 529 $12K
31575 197 192 $11K
82570 6,065 5,990 $11K
J7120 Ringers lactate infusion, up to 1000 cc 5,264 5,196 $11K
93880 326 195 $11K
82248 16,242 15,991 $11K
93970 218 135 $11K
90688 1,734 1,634 $10K
95874 366 229 $10K
95811 56 41 $10K
A4557 Lead wires, (e.g., apnea monitor), per pair 907 888 $9K
90674 896 888 $9K
95251 746 733 $9K
E0776 Iv pole 1,234 1,208 $9K
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans 341 339 $9K
82948 2,783 2,673 $8K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 359 346 $8K
76770 269 176 $8K
90670 138 124 $8K
G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes 104 87 $8K
A0425 Ground mileage, per statute mile 412 401 $8K
ATP08 2,192 2,070 $8K
G0297 Low dose ct scan (ldct) for lung cancer screening 125 96 $7K
72141 184 181 $7K
G0127 Trimming of dystrophic nails, any number 1,861 1,807 $7K
99217 271 268 $7K
82746 1,372 1,340 $7K
94010 580 378 $7K
99454 859 824 $7K
99307 1,551 1,149 $7K
73110 473 250 $7K
11719 1,371 1,326 $6K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 405 372 $6K
86708 916 910 $6K
83735 2,499 2,408 $6K
99457 1,254 1,214 $6K
46221 41 41 $6K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 567 553 $6K
73565 522 299 $6K
86706 1,000 993 $6K
A4556 Electrodes, (e.g., apnea monitor), per pair 910 894 $6K
99070 82 81 $5K
A4649 Surgical supply; miscellaneous 1,240 635 $5K
88342 206 204 $5K
85652 4,426 4,382 $5K
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 549 542 $5K
80048 Basic metabolic panel (calcium, ionized) 12,138 11,565 $5K
70486 95 64 $5K
74178 41 28 $5K
G0008 Administration of influenza virus vaccine 2,865 2,645 $5K
99458 883 853 $5K
97163 126 125 $5K
95044 52 27 $5K
94618 343 321 $5K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 2,586 2,500 $5K
86140 1,553 1,536 $4K
43249 12 12 $4K
82947 5,735 4,937 $4K
83014 773 767 $4K
A5500 For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe 259 151 $4K
J3490 Unclassified drugs 798 747 $4K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,238 1,187 $4K
76775 215 144 $4K
85610 2,196 2,118 $4K
72040 281 169 $4K
90756 337 279 $3K
83721 567 565 $3K
ATP11 717 716 $3K
99318 140 139 $3K
82962 7,204 6,760 $3K
93923 140 99 $3K
93926 48 38 $3K
J1030 Injection, methylprednisolone acetate, 40 mg 680 639 $3K
90677 32 31 $3K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 1,077 770 $3K
ATP07 715 710 $3K
A5512 For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each 131 88 $3K
99000 25,915 24,902 $3K
80076 7,621 7,366 $2K
93296 389 384 $2K
88312 71 71 $2K
82565 3,175 3,144 $2K
99199 Unlisted special service, procedure or report 135 133 $2K
95886 55 54 $2K
99495 37 37 $2K
88313 101 101 $2K
81015 1,088 1,065 $2K
11055 127 124 $2K
74183 41 41 $2K
73221 40 36 $2K
94760 1,459 1,377 $2K
95812 79 73 $2K
G0444 Annual depression screening, 5 to 15 minutes 1,396 1,352 $2K
73564 135 81 $2K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 66 66 $1K
81002 961 905 $1K
84460 3,514 3,482 $1K
A7001 Canister, non-disposable, used with suction pump, each 826 812 $1K
84450 3,535 3,504 $1K
91065 30 12 $1K
ATP13 260 260 $1K
64615 13 13 $1K
99496 29 25 $1K
99348 27 26 $1K
86803 131 130 $1K
ATP06 389 388 $1K
97535 Self-care/home management training, each 15 minutes 562 561 $1K
92370 91 89 $996.90
90673 13 13 $918.39
93294 97 96 $889.42
90661 176 176 $846.70
S8301 Infection control supplies, not otherwise specified 82 81 $825.00
ATP02 381 374 $821.61
82550 2,286 2,237 $818.34
G0399 Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation 21 13 $818.06
99343 14 14 $815.46
ATP16 141 137 $803.11
94664 87 82 $756.32
99219 12 12 $727.93
93793 226 176 $696.29
99201 38 38 $671.46
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 22 21 $618.80
90662 78 65 $615.97
ATP05 175 175 $604.50
E1399 Durable medical equipment, miscellaneous 72 68 $579.31
74018 58 41 $521.10
86705 78 78 $514.46
51798 150 148 $509.05
A7002 Tubing, used with suction pump, each 831 820 $488.09
20553 13 13 $479.75
90732 12 12 $478.58
0012A 13 13 $454.28
87340 80 80 $429.04
84520 1,264 1,252 $418.65
ATP10 91 91 $412.16
43450 12 12 $397.56
72110 20 12 $375.50
80051 637 629 $345.85
20611 12 12 $345.43
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 48 48 $344.78
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 18 12 $324.98
0064A 13 13 $321.09
99152 93 93 $320.90
84132 708 695 $320.55
J0585 Injection, onabotulinumtoxina, 1 unit 26 26 $287.37
72072 20 13 $287.22
81003 266 250 $273.39
92134 12 12 $221.18
99306 Prolong nursin fac eval 15m 27 26 $208.29
73080 20 12 $200.40
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) 13 13 $189.91
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 79 63 $181.94
A4624 Tracheal suction catheter, any type other than closed system, each 722 710 $181.17
93280 14 13 $177.75
E0700 Safety equipment, device or accessory, any type 452 443 $176.28
90656 26 25 $176.16
84153 15 15 $137.12
99350 Prolong home eval add 15m 49 46 $129.87
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 395 303 $127.94
ATP19 38 38 $125.51
99385 12 12 $103.30
86431 26 25 $95.89
76937 31 26 $95.02
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) 25 25 $90.03
ATP09 37 36 $89.60
G0009 Administration of pneumococcal vaccine 131 111 $86.56
83690 27 24 $82.09
85014 60 60 $77.28
J3010 Injection, fentanyl citrate, 0.1 mg 57 57 $75.31
76514 17 17 $73.10
36416 1,382 1,265 $64.47
84550 137 135 $63.81
J1885 Injection, ketorolac tromethamine, per 15 mg 55 55 $57.57
S1015 Iv tubing extension set 42 41 $57.00
J7050 Infusion, normal saline solution, 250 cc 56 41 $51.30
85018 39 32 $40.20
99453 116 116 $19.09
95012 13 12 $17.52
J0280 Injection, aminophyllin, up to 250 mg 12 12 $13.30
J1100 Injection, dexamethasone sodium phosphate, 1 mg 65 62 $7.88
96127 14 14 $5.52
82950 18 13 $3.60
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 12 12 $1.03
2022F 1,009 1,006 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 148 148 $0.00
3FA11 14 13 $0.00
A4550 Surgical trays 39 38 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 1,217 1,179 $0.00
2023F 626 626 $0.00
1220F 865 836 $0.00
G0442 Annual alcohol misuse screening, 5 to 15 minutes 15 15 $0.00
99056 13 13 $0.00