Medicaid Provider Spending

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

GRAND CONCOURSE MEDICAL PRACTICE, P.C.

NPI: 1265744197 · BRONX, NY 10453 · Internal Medicine Physician · NPI assigned 07/08/2010

$155K
Total Medicaid Paid
172,491
Total Claims
170,488
Beneficiaries
102
Codes Billed
2018-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialMEJIA, MANUEL (MEDICAL DIRECTOR)
NPI Enumeration Date07/08/2010

Related Entities

Other providers sharing the same authorized official: MEJIA, MANUEL

ProviderCityStateTotal Paid
TUVIDA MEDICAL PRACTICE, PLLC NEW YORK NY $105K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 27,740 $79K
2019 26,748 $35K
2020 15,455 $9K
2021 23,963 $14K
2022 28,686 $2K
2023 28,351 $11K
2024 21,548 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5,940 5,838 $46K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 1,911 1,910 $16K
G0444 Annual depression screening, 5 to 15 minutes 1,087 1,077 $12K
G0442 Annual alcohol misuse screening, 5 to 15 minutes 847 839 $9K
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes 526 518 $9K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 6,799 6,722 $9K
93000 567 564 $7K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 720 714 $7K
G0270 Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes 291 285 $4K
90686 293 293 $4K
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 255 251 $4K
H0001 Alcohol and/or drug assessment 8,076 7,991 $4K
3078F 4,142 4,104 $3K
3074F 3,787 3,757 $3K
90674 332 330 $3K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 103 103 $3K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 408 407 $2K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 192 187 $2K
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 7,694 7,606 $1K
3079F 1,396 1,387 $1K
3075F 1,289 1,282 $1K
36415 Collection of venous blood by venipuncture 2,553 2,506 $905.44
94760 7,864 7,775 $814.86
3077F 614 606 $655.00
90658 74 73 $604.39
99385 28 28 $542.57
1159F 5,248 5,189 $425.85
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 625 624 $366.00
1160F 5,315 5,231 $357.93
1125F 983 981 $323.02
1126F 3,954 3,917 $281.97
99408 61 61 $110.45
3080F 51 50 $97.50
90656 19 19 $79.57
A4930 Gloves, sterile, per pair 1,577 1,534 $73.66
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 257 257 $25.00
G8730 Pain assessment documented as positive using a standardized tool and a follow-up plan is documented 532 531 $20.49
90460 Immunization administration through 18 years of age via any route, first or only component 30 29 $10.00
80061 Lipid panel 27 27 $6.04
G9507 Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs) 1,111 1,099 $0.25
3061F 458 457 $0.08
3044F 201 199 $0.07
3050F 142 141 $0.06
3049F 34 34 $0.05
3048F 84 82 $0.03
1003F 316 315 $0.00
G9150 National committee for quality assurance - level 3 medical home 8,018 7,912 $0.00
G9622 Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method 5,429 5,367 $0.00
G8731 Pain assessment using a standardized tool is documented as negative, no follow-up plan required 2,041 2,013 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 1,332 1,324 $0.00
4013F 833 823 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 5,792 5,750 $0.00
1033F 5,359 5,297 $0.00
3725F 6,123 6,033 $0.00
3016F 4,213 4,166 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 958 945 $0.00
0556F 257 256 $0.00
G8404 Lower extremity neurological exam performed and documented 735 735 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 38 38 $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) 34 34 $0.00
G8935 Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy 212 211 $0.00
G8482 Influenza immunization administered or previously received 30 29 $0.00
G8484 Influenza immunization was not administered, reason not given 245 242 $0.00
3288F 20 20 $0.00
G8506 Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy 65 64 $0.00
0518F 20 20 $0.00
99397 24 24 $0.00
4274F 20 19 $0.00
99442 13 13 $0.00
1090F 20 20 $0.00
G8950 Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented 514 509 $0.00
2010F 6,136 6,070 $0.00
3008F 6,378 6,287 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 6,739 6,686 $0.00
1036F 5,852 5,780 $0.00
G9275 Documentation that patient is a current non-tobacco user 7,193 7,104 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 1,131 1,114 $0.00
1000F 5,983 5,902 $0.00
99000 2,423 2,380 $0.00
1220F 5,641 5,561 $0.00
4086F 159 155 $0.00
0012A 24 24 $0.00
3017F 122 120 $0.00
G0103 Prostate cancer screening; prostate specific antigen test (psa) 151 148 $0.00
G9664 Patients who are currently statin therapy users or received an order (prescription) for statin therapy 1,094 1,081 $0.00
H0002 Behavioral health screening to determine eligibility for admission to treatment program 480 472 $0.00
3011F 250 249 $0.00
3014F 28 28 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 166 165 $0.00
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 179 177 $0.00
91301 100 100 $0.00
G0432 Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening 339 336 $0.00
1101F 20 20 $0.00
4010F 172 172 $0.00
97802 138 136 $0.00
4008F 26 26 $0.00
G8734 Elder maltreatment screen documented as negative, follow-up is not required 33 33 $0.00
2000F 144 136 $0.00
G9228 Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) 44 44 $0.00
0011A 48 48 $0.00
1170F 18 18 $0.00
2001F 122 122 $0.00