Medicaid Provider Spending

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

CHILDREN'S HOSPITAL OF ORANGE COUNTY

NPI: 1275975104 · ORANGE, CA 92868 · Developmental - Behavioral Pediatrics Physician · NPI assigned 07/19/2013

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

Authorized official KELLY, MARK controls 20+ related entities in our dataset. Read more

$2.14M
Total Medicaid Paid
129,288
Total Claims
108,413
Beneficiaries
143
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialKELLY, MARK (CS DIRECTOR, BUSINESS SERVICES)
Parent OrganizationCHILDREN'S HOSPITAL OF ORANGE COUNTY
NPI Enumeration Date07/19/2013

Related Entities

Other providers sharing the same authorized official: KELLY, MARK

ProviderCityStateTotal Paid
ST. FRANCIS MEDICAL CENTER TRENTON NJ $30.60M
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC. MONTEBELLO CA $18.75M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $11.86M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $8.23M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $5.33M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $5.33M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $4.84M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $4.74M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $4.70M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $4.31M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $3.82M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $3.47M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $3.10M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $2.09M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.93M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.47M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.43M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.31M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.25M
CHILDREN'S HOSPITAL OF ORANGE ORANGE CA $998K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 10,095 $69K
2019 20,883 $447K
2020 12,348 $207K
2021 14,753 $272K
2022 23,330 $472K
2023 29,864 $610K
2024 18,015 $67K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 12,235 3,963 $415K
99215 Prolong outpt/office vis 5,524 4,730 $346K
99233 Prolong inpt eval add15 m 2,824 576 $176K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 8,041 7,764 $154K
97530 Therapeutic activities, direct patient contact, each 15 minutes 2,105 671 $117K
99244 Office or other outpatient consultation, moderate to high complexity 1,132 1,106 $108K
99245 801 796 $89K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 16,205 15,391 $78K
99232 Subsequent hospital care, per day, moderate complexity 1,189 391 $64K
G9920 Screening performed and negative 4,656 4,646 $40K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 176 161 $40K
99222 Initial hospital care, per day, moderate complexity 366 354 $39K
S0302 Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) 779 474 $37K
92567 999 995 $32K
92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder 828 229 $29K
99238 Hospital discharge day management, 30 minutes or less 580 562 $29K
99223 Prolong inpt eval add15 m 259 238 $26K
92587 452 449 $24K
76705 Ultrasound, abdominal, real time with image documentation; limited 1,192 900 $20K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 139 124 $20K
92060 548 544 $19K
93325 291 256 $19K
96156 6,353 6,338 $18K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 837 747 $17K
99255 144 112 $15K
92523 145 144 $14K
92557 173 170 $14K
92522 144 143 $13K
93320 142 126 $13K
71046 Radiologic examination, chest; 2 views 1,535 1,273 $12K
93000 268 260 $11K
92551 3,912 3,907 $9K
99354 93 52 $7K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,283 1,262 $7K
90686 2,473 2,439 $7K
94375 608 480 $7K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,009 1,002 $6K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 480 466 $5K
92588 69 68 $5K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 593 591 $4K
92579 112 112 $4K
71045 Radiologic examination, chest; single view 387 189 $3K
99234 4,664 4,447 $3K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 37 37 $3K
93975 32 25 $2K
74018 222 157 $2K
99239 Hospital discharge day management, more than 30 minutes 26 25 $2K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 19 15 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,358 2,290 $2K
70450 Computed tomography, head or brain; without contrast material 54 49 $2K
92015 Determination of refractive state 43 43 $1K
99000 890 875 $837.89
99460 13 13 $812.36
0510 2,473 2,342 $740.17
76770 47 40 $732.47
96110 Developmental screening, with scoring and documentation, per standardized instrument 312 217 $718.80
92582 14 14 $700.26
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 76 75 $650.06
99283 Emergency department visit for the evaluation and management, moderate severity 2,786 2,605 $646.70
G8510 Screening for depression is documented as negative, a follow-up plan is not required 1,141 1,119 $618.00
92552 15 15 $579.81
90460 Immunization administration through 18 years of age via any route, first or only component 3,305 2,892 $530.02
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 209 209 $497.86
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 587 576 $471.66
0450 Emergency room services 4,171 3,865 $463.87
73610 72 52 $416.18
99174 825 782 $360.00
90671 73 73 $341.82
81002 156 139 $328.42
0761 106 101 $326.60
73110 52 37 $323.68
99050 252 249 $305.92
92555 15 15 $262.09
G0444 Annual depression screening, 5 to 15 minutes 97 96 $255.32
73080 35 25 $250.78
90688 113 113 $238.42
0760 763 734 $220.08
90697 34 34 $193.73
73630 18 12 $97.62
80053 Comprehensive metabolic panel 1,393 1,102 $93.78
90461 707 686 $88.40
0710 72 69 $54.12
90674 257 256 $46.09
90661 125 125 $36.85
90651 150 149 $36.00
99173 2,717 2,712 $29.56
90472 Immunization administration, each additional vaccine (list separately) 468 253 $27.52
85025 Blood count; complete (CBC), automated, and automated differential WBC count 635 526 $19.77
90633 141 141 $17.82
83036 Hemoglobin; glycosylated (A1C) 199 197 $13.66
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 49 26 $12.76
85027 91 77 $9.14
90698 43 43 $8.91
81001 703 658 $8.42
86140 376 359 $6.99
85007 187 144 $6.51
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 42 39 $5.77
81025 14 14 $4.02
0270 229 174 $0.02
0320 39 29 $0.00
0300 179 111 $0.00
90670 96 96 $0.00
A0429 Ambulance service, basic life support, emergency transport (bls-emergency) 2,784 2,060 $0.00
84550 22 13 $0.00
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 43 43 $0.00
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 61 54 $0.00
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 43 43 $0.00
J2405 Injection, ondansetron hydrochloride, per 1 mg 58 38 $0.00
0123 52 51 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 27 27 $0.00
84100 23 12 $0.00
G9656 Patient transferred directly from anesthetizing location to pacu or other non-icu location 12 12 $0.00
90715 16 16 $0.00
99199 Unlisted special service, procedure or report 27 16 $0.00
87634 15 15 $0.00
S9451 Exercise classes, non-physician provider, per session 3,012 3,003 $0.00
0306 112 97 $0.00
97802 3,251 3,238 $0.00
J3490 Unclassified drugs 1,256 835 $0.00
87086 Culture, bacterial; quantitative colony count, urine 445 418 $0.00
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 14 13 $0.00
0636 81 75 $0.00
87430 12 12 $0.00
96375 Therapeutic injection; each additional sequential IV push 14 12 $0.00
0250 168 155 $0.00
0305 48 32 $0.00
96127 35 33 $0.00
96361 Intravenous infusion, hydration; each additional hour 33 29 $0.00
83615 43 26 $0.00
90619 65 65 $0.00
0301 93 70 $0.00
0258 40 39 $0.00
A9150 Non-prescription drugs 45 39 $0.00
87486 31 31 $0.00
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen 31 31 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 46 34 $0.00
87428 38 38 $0.00
0370 12 12 $0.00
90620 13 13 $0.00
J2704 Injection, propofol, 10 mg 14 14 $0.00
87581 31 31 $0.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 12 12 $0.00
G0378 Hospital observation service, per hour 12 12 $0.00