Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Prospect Chartercare RWMC, LLC

Prospect Chartercare RWMC, LLC was paid $2.38M by Medicaid between Jan 2018 and Dec 2024, across 101 billing codes. Its largest line is 99283, emergency room visit (moderate) — 21% of everything it billed.

33Billing provider infoPROSPECT CHARTERCARE RWMC, LLC
PROVIDENCE, RI 02908
33aNPI1285059287assigned 02/27/2014
33bProvider typeAddiction Medicine (Internal Medicine) Physician
28Total paid$2.38M
24GClaims54,829
24DCodes billed101
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Addiction Medicine (Internal Medicine) Physician providers in Rhode Island

Rank by total paid#2 of 8
Median peer was paid$64K
This provider vs. median37×

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.

Box 24A · Dates of service

Paid by month

$0$50K$100K$150K2018201920202021202220232024
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
201820,717$783K
201910,407$429K
20209,217$410K
20215,370$211K
20222,131$105K
20234,013$253K
2024incomplete2,974$191K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 21% 1,973 1,596 $496K
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 9.9% 4,534 3,631 $236K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 7.4% 665 248 $176K
90791 Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation 7.1% 1,916 1,722 $169K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 5.7% 6,680 2,338 $136K
99223 Prolong inpt eval add15 m 5.5% 1,475 1,398 $130K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 4.6% 2,534 1,940 $110K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 2.7% 862 307 $65K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 2.7% 860 314 $63K
99282 Emergency department visit for the evaluation and management, low to moderate severity 2.6% 378 302 $61K
99239 Hospital discharge day management, more than 30 minutes 2.3% 1,234 1,177 $54K
96375 Therapeutic injection; each additional sequential IV push 1.9% 362 188 $44K
89 more codes
80053 Comprehensive metabolic panel 1.8% 2,711 $44K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1.8% 3,958 $43K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1.7% 893 $41K
99285 Emergency room visit (most serious) 1.5% 166 $37K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1.5% 94 $37K
84443 Thyroid stimulating hormone (TSH) 1.5% 1,388 $35K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 1.3% 203 $31K
88305 Level IV - Surgical pathology, gross and microscopic examination 1.2% 442 $29K
80061 Lipid panel 1.2% 1,339 $28K
99222 Initial hospital care, per day, moderate complexity <1% 254 $20K
99233 Hospital visit by a doctor, follow-up day (complex) <1% 282 $16K
82607 <1% 699 $16K
90792 Psychiatric diagnostic evaluation with medical services <1% 157 $16K
90832 Psychotherapy session, about 30 minutes <1% 397 $16K
83036 Hemoglobin; glycosylated (A1C) <1% 1,150 $15K
80048 Basic metabolic panel (calcium, ionized) <1% 1,522 $15K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 397 $14K
86141 <1% 675 $13K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 83 $12K
82728 <1% 566 $12K
80305 <1% 763 $11K
99203 Doctor's office visit, new patient (routine) <1% 129 $11K
85027 <1% 1,020 $10K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 157 $9K
84439 <1% 495 $7K
83540 <1% 598 $6K
99284 Emergency room visit (serious) <1% 82 $6K
85610 <1% 1,031 $6K
80076 <1% 521 $5K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 86 $5K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 86 $5K
84466 <1% 257 $5K
71046 Radiologic examination, chest; 2 views <1% 307 $4K
94726 <1% 74 $4K
84460 <1% 485 $4K
94729 <1% 72 $4K
84450 <1% 474 $4K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml <1% 35 $4K
82565 <1% 479 $3K
81001 <1% 816 $3K
82746 <1% 212 $3K
85652 <1% 768 $3K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 26 $3K
86803 <1% 133 $3K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 22 $2K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 334 $2K
84100 <1% 341 $2K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 86 $2K
83735 <1% 195 $2K
90785 <1% 398 $2K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 249 $2K
87086 Culture, bacterial; quantitative colony count, urine <1% 202 $1K
94060 <1% 20 $1K
85045 <1% 179 $993.32
96415 <1% 15 $971.52
84207 <1% 23 $715.19
82043 <1% 89 $673.01
82550 <1% 77 $568.52
86850 <1% 78 $529.17
G0463 Hospital outpatient clinic visit for assessment and management of a patient <1% 99 $426.60
84154 <1% 13 $404.43
84480 <1% 22 $386.46
86900 <1% 86 $374.18
86901 <1% 86 $369.80
87340 <1% 19 $282.96
84520 <1% 59 $280.51
84425 <1% 29 $264.91
85730 <1% 32 $254.44
88342 <1% 12 $246.87
82040 <1% 42 $204.79
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 216 $174.56
82947 <1% 35 $148.86
84550 <1% 23 $143.64
87081 <1% 60 $91.56
87186 <1% 26 $78.36
81025 <1% 68 $77.98
J1644 Injection, heparin sodium, per 1000 units <1% 332 $66.45
84484 <1% 70 $58.54
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 376 $38.43
99221 <1% 31 $38.18
99307 <1% 87 $18.58
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 97 $12.50
J3010 Injection, fentanyl citrate, 0.1 mg <1% 168 $7.04
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 177 $6.88
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 39 $1.82
82962 0% 76 $0.00
99308 Subsequent nursing facility care, per day, straightforward 0% 39 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 0% 52 $0.00
99238 Hospital discharge day management, 30 minutes or less 0% 95 $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 officialSABILLO, ALFREDO (SENIOR VICE PRESIDENT)