Prohealth Care Associates LLP
Prohealth Care Associates LLP was paid $69.52M by Medicaid between Jan 2018 and Nov 2022, across 291 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 22% of everything it billed.
LAKE SUCCESS, NY 11042
Next to other Pain Medicine (Anesthesiology) Physician providers in New York
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 110,800 | $8.42M | |
| 2019 | 247,127 | $14.39M | |
| 2020 | 263,795 | $15.73M | |
| 2021 | 305,764 | $20.78M | |
| 2022 | 133,926 | $10.20M |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 22% | 166,250 | 154,441 | $15.01M |
| 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 | 11% | 58,386 | 55,920 | $7.51M |
| S9083 | Global fee urgent care centers | 8.6% | 34,114 | 31,020 | $5.98M |
| 76641 | 3.6% | 24,916 | 22,669 | $2.53M | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 3.3% | 20,230 | 20,195 | $2.28M |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.2% | 20,603 | 20,568 | $2.25M |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 3.1% | 60,565 | 25,651 | $2.14M |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 2.7% | 49,518 | 20,040 | $1.89M |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 2.4% | 15,361 | 15,340 | $1.69M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.0% | 61,543 | 60,951 | $1.41M |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 2.0% | 32,780 | 13,228 | $1.39M |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 1.9% | 45,590 | 19,419 | $1.34M |
279 more codes
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 1.7% | 9,199 | $1.19M |
| 92060 | 1.7% | 16,096 | $1.16M | |
| 99204 | Doctor's office visit, new patient (more involved) | 1.5% | 6,299 | $1.05M |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 1.2% | 3,563 | $835K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 1.2% | 9,792 | $822K |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 1.1% | 3,261 | $788K |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 1.1% | 3,310 | $760K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 4,036 | $666K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 6,286 | $611K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 5,992 | $596K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 6,035 | $563K |
| 74183 | <1% | 1,329 | $542K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 11,616 | $523K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 6,305 | $512K |
| 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% | 8,570 | $494K |
| 76536 | <1% | 5,094 | $488K | |
| 76830 | Ultrasound, transvaginal | <1% | 4,799 | $475K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 16,949 | $475K |
| 78815 | Positron emission tomography (PET) for limited area imaging | <1% | 417 | $470K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 1,214 | $462K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 13,778 | $454K |
| 31231 | <1% | 1,878 | $425K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 3,765 | $399K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 3,666 | $384K |
| 72197 | <1% | 970 | $379K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 3,462 | $372K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 881 | $335K |
| 19083 | <1% | 484 | $323K | |
| 77065 | Tomosynthesis, mammo | <1% | 2,906 | $322K |
| 72141 | <1% | 1,369 | $308K | |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | <1% | 5,027 | $299K |
| 92250 | <1% | 6,600 | $287K | |
| 71250 | <1% | 1,697 | $248K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,230 | $216K |
| 73221 | <1% | 893 | $215K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 20,419 | $203K |
| 75574 | <1% | 650 | $189K | |
| 76770 | <1% | 1,811 | $170K | |
| 92015 | Determination of refractive state | <1% | 15,209 | $169K |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | <1% | 931 | $165K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 10,398 | $164K |
| 77066 | Tomosynthesis, mammo | <1% | 1,162 | $163K |
| 87428 | <1% | 3,245 | $162K | |
| 97161 | <1% | 2,513 | $156K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 1,668 | $155K |
| 73630 | <1% | 5,052 | $148K | |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | <1% | 463 | $124K |
| 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% | 6,516 | $120K |
| 90461 | <1% | 4,248 | $115K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 450 | $113K |
| 92551 | <1% | 10,767 | $107K | |
| 92557 | <1% | 2,603 | $101K | |
| 77080 | <1% | 2,777 | $100K | |
| 92552 | <1% | 3,232 | $98K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 597 | $94K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 818 | $88K |
| 76642 | <1% | 1,175 | $81K | |
| 96127 | <1% | 16,825 | $79K | |
| 41010 | <1% | 292 | $79K | |
| 70486 | <1% | 583 | $79K | |
| 73562 | <1% | 2,317 | $78K | |
| 74178 | <1% | 243 | $73K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 13,448 | $73K |
| 52000 | <1% | 294 | $72K | |
| 92587 | <1% | 3,427 | $72K | |
| 92567 | <1% | 4,514 | $72K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 611 | $69K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 338 | $68K |
| 95117 | <1% | 5,059 | $67K | |
| 99205 | Prolong outpt/office vis | <1% | 414 | $63K |
| 92082 | <1% | 1,124 | $58K | |
| 58340 | <1% | 233 | $55K | |
| 36902 | <1% | 53 | $52K | |
| 73610 | <1% | 1,624 | $49K | |
| 17110 | <1% | 365 | $48K | |
| 77049 | <1% | 146 | $47K | |
| 93303 | Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study | <1% | 305 | $46K |
| 31575 | <1% | 309 | $45K | |
| 97535 | Self-care/home management training, each 15 minutes | <1% | 1,738 | $44K |
| 72110 | <1% | 1,002 | $44K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 4,537 | $42K |
| 92588 | <1% | 843 | $40K | |
| 73130 | <1% | 1,318 | $40K | |
| J2785 | Injection, regadenoson, 0.1 mg | <1% | 267 | $36K |
| 72100 | <1% | 1,105 | $36K | |
| 93970 | <1% | 196 | $35K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 271 | $34K |
| 88313 | <1% | 235 | $32K | |
| 73620 | <1% | 1,021 | $31K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 252 | $30K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 771 | $29K |
| 93000 | <1% | 1,688 | $27K | |
| A9579 | Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml | <1% | 1,267 | $27K |
| 73030 | <1% | 992 | $27K | |
| 81003 | <1% | 16,112 | $26K | |
| 73718 | <1% | 83 | $23K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 4,157 | $20K |
| 93015 | <1% | 281 | $20K | |
| 11750 | <1% | 116 | $19K | |
| 88342 | <1% | 224 | $19K | |
| 93976 | <1% | 105 | $17K | |
| 94010 | <1% | 468 | $17K | |
| 92226 | <1% | 688 | $16K | |
| 10040 | <1% | 117 | $16K | |
| 77072 | <1% | 782 | $16K | |
| 92133 | <1% | 385 | $15K | |
| 51798 | <1% | 1,054 | $14K | |
| 92201 | <1% | 628 | $14K | |
| 99173 | <1% | 8,130 | $14K | |
| 99201 | <1% | 155 | $14K | |
| 72040 | <1% | 432 | $13K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 560 | $13K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 559 | $13K |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 179 | $13K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 109 | $12K |
| 87184 | <1% | 2,120 | $11K | |
| 88112 | <1% | 188 | $11K | |
| 87081 | <1% | 2,531 | $11K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 29 | $11K |
| 99152 | <1% | 235 | $11K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 177 | $10K |
| 77061 | <1% | 238 | $10K | |
| 92550 | <1% | 437 | $10K | |
| 76376 | <1% | 1,013 | $10K | |
| 99223 | Prolong inpt eval add15 m | <1% | 49 | $9K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 87 | $9K |
| 36415 | Collection of venous blood by venipuncture | <1% | 10,004 | $9K |
| 81025 | <1% | 2,135 | $8K | |
| 73110 | <1% | 257 | $8K | |
| 77062 | <1% | 194 | $8K | |
| 88341 | <1% | 91 | $8K | |
| 82565 | <1% | 1,708 | $8K | |
| A9575 | Injection, gadoterate meglumine, 0.1 ml | <1% | 2,654 | $7K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 153 | $7K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 94 | $7K |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | <1% | 234 | $7K |
| 97014 | <1% | 671 | $7K | |
| 99177 | <1% | 1,504 | $7K | |
| 64615 | <1% | 37 | $7K | |
| 99188 | <1% | 412 | $7K | |
| 99441 | <1% | 283 | $6K | |
| 73560 | <1% | 200 | $6K | |
| 97162 | <1% | 68 | $6K | |
| 74740 | <1% | 99 | $6K | |
| 69210 | <1% | 194 | $6K | |
| J0585 | Injection, onabotulinumtoxina, 1 unit | <1% | 17 | $6K |
| 20550 | <1% | 90 | $6K | |
| 99385 | <1% | 47 | $6K | |
| 81002 | <1% | 2,492 | $5K | |
| 92285 | <1% | 313 | $5K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 28 | $5K |
| 93880 | <1% | 39 | $5K | |
| 92504 | <1% | 386 | $5K | |
| 87807 | <1% | 530 | $5K | |
| 95806 | <1% | 40 | $4K | |
| 86769 | <1% | 99 | $4K | |
| 99478 | <1% | 34 | $4K | |
| 99000 | <1% | 14,525 | $4K | |
| 90686 | <1% | 9,842 | $4K | |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | <1% | 14 | $4K |
| 20600 | <1% | 64 | $4K | |
| 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% | 26 | $3K |
| 72146 | <1% | 14 | $3K | |
| 93971 | <1% | 25 | $3K | |
| 74018 | <1% | 123 | $3K | |
| 97113 | <1% | 46 | $3K | |
| 97010 | <1% | 14,670 | $3K | |
| 93925 | <1% | 12 | $3K | |
| 85018 | <1% | 1,499 | $3K | |
| 99051 | <1% | 753 | $3K | |
| 76775 | <1% | 45 | $3K | |
| 77085 | <1% | 69 | $2K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 170 | $2K |
| 88304 | <1% | 59 | $2K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 12 | $2K |
| 76870 | <1% | 26 | $2K | |
| 51741 | <1% | 170 | $2K | |
| 92202 | <1% | 114 | $2K | |
| 95886 | <1% | 13 | $2K | |
| 84153 | <1% | 115 | $2K | |
| 80061 | Lipid panel | <1% | 331 | $2K |
| 92225 | <1% | 68 | $2K | |
| 0072A | <1% | 44 | $2K | |
| 0012A | <1% | 47 | $2K | |
| 0071A | <1% | 40 | $2K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 17 | $2K |
| 11900 | <1% | 27 | $2K | |
| 95018 | <1% | 30 | $2K | |
| 76801 | <1% | 15 | $2K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 810 | $2K |
| 46600 | <1% | 13 | $2K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 93 | $1K |
| 73100 | <1% | 44 | $1K | |
| 96160 | <1% | 995 | $1K | |
| 94760 | <1% | 3,118 | $1K | |
| 90688 | <1% | 77 | $1K | |
| 97165 | <1% | 27 | $1K | |
| 99243 | <1% | 14 | $1K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 51 | $1K |
| 76882 | <1% | 27 | $1K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 14 | $1K |
| 73502 | <1% | 30 | $1K | |
| 97116 | <1% | 60 | $1K | |
| 72070 | <1% | 33 | $1K | |
| 97022 | <1% | 67 | $972.91 | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 12 | $958.70 |
| 72083 | <1% | 15 | $954.85 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 134 | $897.93 |
| 97802 | <1% | 305 | $788.66 | |
| 0011A | <1% | 22 | $785.64 | |
| 86580 | <1% | 115 | $783.78 | |
| 99050 | <1% | 27 | $777.06 | |
| 76857 | <1% | 16 | $770.05 | |
| 20605 | <1% | 14 | $731.82 | |
| 0001A | <1% | 15 | $660.12 | |
| 72082 | <1% | 12 | $617.70 | |
| 72050 | <1% | 13 | $589.74 | |
| 0002A | <1% | 13 | $580.72 | |
| 99401 | <1% | 77 | $560.10 | |
| 90651 | <1% | 289 | $546.84 | |
| 84439 | <1% | 102 | $512.75 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 69 | $498.69 |
| 84520 | <1% | 142 | $493.16 | |
| 97803 | <1% | 13 | $479.45 | |
| 80053 | Comprehensive metabolic panel | <1% | 78 | $443.06 |
| 83655 | <1% | 38 | $434.17 | |
| 99408 | <1% | 179 | $421.70 | |
| 81001 | <1% | 152 | $421.03 | |
| 90756 | <1% | 14 | $404.63 | |
| 71100 | <1% | 12 | $389.29 | |
| 70210 | <1% | 13 | $364.75 | |
| 73080 | <1% | 14 | $333.75 | |
| 82465 | <1% | 131 | $301.52 | |
| 81000 | <1% | 87 | $296.14 | |
| 73140 | <1% | 12 | $266.90 | |
| 72220 | <1% | 13 | $246.14 | |
| 95012 | <1% | 13 | $245.95 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 41 | $240.65 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 285 | $220.00 |
| 90670 | <1% | 873 | $215.84 | |
| 94667 | <1% | 47 | $202.44 | |
| 84480 | <1% | 12 | $201.27 | |
| 84436 | <1% | 60 | $193.56 | |
| 94664 | <1% | 47 | $187.87 | |
| 85652 | <1% | 95 | $173.83 | |
| 90621 | <1% | 60 | $159.33 | |
| 90734 | <1% | 424 | $139.29 | |
| 85027 | <1% | 75 | $137.06 | |
| 84479 | <1% | 47 | $114.04 | |
| 80050 | General health panel | <1% | 32 | $109.06 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 13 | $99.80 |
| 36416 | <1% | 2,578 | $75.56 | |
| 96161 | <1% | 43 | $66.27 | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | <1% | 44 | $40.85 |
| 90656 | <1% | 59 | $19.77 | |
| 99172 | <1% | 12 | $16.14 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 56 | $2.62 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 13 | $2.14 |
| 90698 | 0% | 810 | $0.00 | |
| 90696 | 0% | 15 | $0.00 | |
| 99024 | 0% | 118 | $0.00 | |
| 90680 | 0% | 261 | $0.00 | |
| 90744 | 0% | 104 | $0.00 | |
| 90694 | 0% | 14 | $0.00 | |
| 82962 | 0% | 34 | $0.00 | |
| 90619 | 0% | 13 | $0.00 | |
| 90716 | 0% | 14 | $0.00 | |
| 99070 | 0% | 12 | $0.00 | |
| 0502F | 0% | 778 | $0.00 | |
| 90672 | 0% | 79 | $0.00 | |
| 90707 | 0% | 12 | $0.00 | |
| 90685 | 0% | 98 | $0.00 | |
| 99080 | 0% | 393 | $0.00 | |
| 90710 | 0% | 26 | $0.00 | |
| 90633 | 0% | 26 | $0.00 | |
| 90715 | 0% | 95 | $0.00 | |
| 90700 | 0% | 14 | $0.00 | |
| 90658 | 0% | 18 | $0.00 | |
| 90648 | 0% | 13 | $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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| C H L EMS INC | Visalia, CA | $10.59M |
| Chester County Pediatrics | Downington, PA | $4.85M |
| Stoddard County Ambulance District | Dexter, MO | $4.67M |
| Tidewater LLC | Lexington Park, MD | $735K |
| DRS. Cooper & Banninger, LLC. | Salina, KS | $587K |
| No Limit Life LLC | Pennsauken, NJ | $366K |
| Tidewater LLC | Lexington Park, MD | $192K |
| Tidewater LLC | Solomons, MD | $82K |
| Tidewater LLC | Prince Frederick, MD | $74K |
| Tidewater LLC | Dunkirk, MD | $21K |
| Tidewater LLC | Lanham, MD | $21K |
| Mobile Medical Services P.C. | New Hyde Park, NY | $3K |
| Chester County Pediatrics PC | Avondale, PA | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.