Medicaid Provider Spending

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

ST. LUKE'S PEDIATRICS

NPI: 1306078514 · PHOENIX, AZ 85008 · Primary Care Clinic/Center · NPI assigned 08/20/2009

$31.61M
Total Medicaid Paid
286,909
Total Claims
210,632
Beneficiaries
74
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialDALOTTO, GUSTAVO (OWNER/CEO)
Parent OrganizationARIZONA FAMILY CLINICS CORP
NPI Enumeration Date08/20/2009

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 8,031 $438K
2019 22,482 $2.56M
2020 23,423 $3.87M
2021 25,645 $4.17M
2022 36,208 $4.98M
2023 71,460 $8.14M
2024 99,660 $7.46M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials 11,522 8,347 $15.03M
95144 40,302 4,185 $5.59M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 48,635 37,859 $3.87M
95004 Percutaneous tests with allergenic extracts, immediate type reaction 7,072 7,052 $1.51M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 23,592 19,721 $1.37M
99401 36,864 27,549 $1.16M
99354 6,870 5,493 $634K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 8,190 5,093 $306K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,219 2,202 $250K
90460 Immunization administration through 18 years of age via any route, first or only component 5,148 5,075 $213K
92100 2,165 2,156 $171K
93922 2,137 2,131 $166K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,491 1,486 $119K
95117 11,161 7,465 $103K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1,145 1,134 $100K
94060 2,199 2,186 $96K
93000 6,563 6,519 $95K
76775 2,249 2,243 $84K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 778 778 $76K
99215 Prolong outpt/office vis 757 713 $69K
81025 8,012 7,016 $61K
36415 Collection of venous blood by venipuncture 13,101 12,667 $48K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 621 609 $45K
99385 416 413 $43K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 389 389 $40K
69210 1,081 924 $39K
94664 2,058 2,042 $32K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2,407 2,011 $31K
95115 3,563 2,295 $29K
96160 10,223 10,167 $28K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 2,184 2,163 $28K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 929 918 $21K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,351 1,318 $19K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 279 254 $18K
92552 610 603 $16K
99383 166 166 $16K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 868 854 $13K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 288 282 $11K
99386 101 98 $10K
81002 3,164 3,043 $9K
99384 73 73 $7K
99382 73 72 $6K
94760 2,661 2,476 $6K
93880 29 29 $5K
90461 229 224 $3K
93976 26 24 $3K
99000 1,805 1,659 $3K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 76 76 $3K
76700 Ultrasound, abdominal, real time with image documentation; complete 40 40 $3K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 32 32 $2K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,093 877 $2K
99173 645 639 $2K
99417 Prolong home eval add 15m 60 54 $762.58
83014 69 69 $569.68
90688 108 108 $232.18
90686 3,423 3,084 $193.44
82962 48 38 $128.52
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 2,118 2,102 $86.11
J1885 Injection, ketorolac tromethamine, per 15 mg 27 25 $10.83
90734 49 48 $0.00
90633 419 377 $0.00
90670 101 100 $0.00
90713 249 223 $0.00
90649 125 123 $0.00
90715 105 98 $0.00
90658 151 151 $0.00
90700 17 12 $0.00
90671 12 12 $0.00
90710 12 12 $0.00
90620 40 40 $0.00
90716 43 36 $0.00
90744 56 55 $0.00
90657 12 12 $0.00
90680 13 13 $0.00