Medicaid Provider Spending

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

PIONEER VALLEY GASTROENTEROLOGY ASSOCIATES, PC

NPI: 1326286998 · HOLYOKE, MA 01040 · Gastroenterology Physician · NPI assigned 02/04/2009

$31K
Total Medicaid Paid
3,411
Total Claims
3,376
Beneficiaries
16
Codes Billed
2018-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialCLIFFORD, BERNARD (OWNER)
NPI Enumeration Date02/04/2009

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 254 $9K
2019 825 $5K
2020 453 $3K
2021 365 $2K
2022 882 $4K
2023 490 $5K
2024 142 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 437 433 $17K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 161 160 $4K
99222 Initial hospital care, per day, moderate complexity 85 83 $4K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 51 51 $3K
99223 Prolong inpt eval add15 m 15 15 $2K
99443 12 12 $167.50
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 900 884 $80.43
G8783 Normal blood pressure reading documented, follow-up not required 407 403 $0.00
G8785 Blood pressure reading not documented, reason not given 335 335 $0.00
G8482 Influenza immunization administered or previously received 13 12 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 31 29 $0.00
G9744 Patient not eligible due to active diagnosis of hypertension 16 16 $0.00
1036F 509 506 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 90 90 $0.00
3017F 320 318 $0.00
G9745 Documented reason for not screening or recommending a follow-up for high blood pressure 29 29 $0.00