Medicaid Provider Spending

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

PINNACLE HEALTH MANAGEMENT, LLC

NPI: 1306104047 · HYDEN, KY 41749 · Clinical Medical Laboratory · NPI assigned 05/01/2012

$13.37M
Total Medicaid Paid
491,828
Total Claims
325,145
Beneficiaries
62
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMARTIN, TONYA (MEMBER)
NPI Enumeration Date05/01/2012

Related Entities

Other providers sharing the same authorized official: MARTIN, TONYA

ProviderCityStateTotal Paid
EDWIN LIU, MD PA LOXAHATCHEE FL $5.97M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 17,659 $830K
2019 21,229 $923K
2020 28,103 $1.10M
2021 161,710 $3.43M
2022 155,782 $3.15M
2023 64,347 $2.18M
2024 42,998 $1.76M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
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 112,653 65,197 $4.91M
G0481 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; 8-14 drug class(es), including metabolite(s) if performed 19,917 17,083 $1.69M
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 36,292 31,585 $1.38M
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 26,106 22,988 $1.02M
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 14,453 11,635 $966K
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 105,409 60,331 $924K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 2,503 2,244 $618K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 21,458 6,225 $380K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 16,497 15,577 $274K
87481 2,049 1,814 $186K
80074 4,048 3,854 $128K
84443 Thyroid stimulating hormone (TSH) 11,367 10,712 $111K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 3,566 3,396 $86K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 3,566 3,396 $86K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 4,483 4,264 $71K
82607 7,642 7,225 $67K
80053 Comprehensive metabolic panel 9,544 8,911 $57K
87641 2,460 2,204 $47K
87500 2,410 2,159 $46K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 2,393 2,141 $46K
80061 Lipid panel 5,184 4,903 $39K
87653 2,104 1,868 $39K
83013 496 461 $22K
82728 2,403 2,263 $21K
86762 1,525 1,470 $16K
86803 1,754 1,676 $15K
84439 2,600 2,443 $13K
84481 1,218 1,154 $12K
83540 2,543 2,397 $10K
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 568 533 $10K
G2024 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source 50,804 11,915 $9K
87340 1,280 1,221 $8K
83735 1,993 1,848 $8K
86706 924 889 $8K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 20 20 $6K
G0475 Hiv antigen/antibody, combination assay, screening 559 529 $6K
86592 1,517 1,426 $4K
86780 368 361 $3K
83690 762 719 $3K
86704 340 335 $3K
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 52 31 $3K
83550 525 489 $2K
86431 756 711 $2K
87802 226 218 $2K
82150 454 428 $2K
83002 151 143 $2K
G0499 Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result 119 116 $2K
87640 250 225 $2K
82746 162 148 $1K
83525 297 278 $1K
84146 105 100 $1K
82670 55 54 $1K
84550 465 438 $1K
G0103 Prostate cancer screening; prostate specific antigen test (psa) 107 91 $599.48
80305 111 106 $553.62
87581 20 20 $549.49
87486 20 20 $549.49
84144 20 14 $399.22
80048 Basic metabolic panel (calcium, ionized) 48 46 $290.01
85025 Blood count; complete (CBC), automated, and automated differential WBC count 53 51 $239.69
83036 Hemoglobin; glycosylated (A1C) 15 15 $127.31
99499 39 31 $0.00