Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › NY › Lake Success › NPI 1275596280
Physician

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.

33Billing provider infoPROHEALTH CARE ASSOCIATES LLP
LAKE SUCCESS, NY 11042
33aNPI1275596280assigned 04/10/2006
33bProvider typePain Medicine (Anesthesiology) Physician
28Total paid$69.52M
24GClaims1,061,412
24DCodes billed291
24AFirst – last monthJan 2018 – Nov 2022
Compared with peers

Next to other Pain Medicine (Anesthesiology) Physician providers in New York

Rank by total paid#1 of 125
Median peer was paid$14K
This provider vs. median4,977×

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 COOPER, DAVID controls 13+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$1.0M$2.0M$3.0M2018201920202021202220232024
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
2018110,800$8.42M
2019247,127$14.39M
2020263,795$15.73M
2021305,764$20.78M
2022133,926$10.20M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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.

From NPPES

Who's on the registration

Authorized officialCOOPER, DAVID (CHIEF EXECUTIVE OFFICER)
Same official

Other billing entities under COOPER, DAVID

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