Providence Health Alliance

Providence Health Alliance was paid $4.75M by Medicaid between Oct 2018 and Dec 2023, across 43 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 84% of everything it billed.

33Billing provider infoPROVIDENCE HEALTH ALLIANCE
WACO, TX 76712

33aNPI1336590462assigned 06/30/2016

33bProvider typeRural Health Clinic/Center

28Total paid$4.75M

24GClaims53,540

24DCodes billed43

24AFirst – last monthOct 2018 – Dec 2023

Compared with peers

Next to other Rural Health Clinic/Center providers in Texas

Rank by total paid#15 of 225

Median peer was paid$428K

This provider vs. median11×

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

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

Year	Claims	Paid
2018	32	$0.00
2019	67	$0.00
2020	3,185	$197K
2021	22,441	$1.57M
2022	15,474	$1.53M
2023	12,341	$1.45M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	84%	29,418	24,507	$4.01M
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	4.2%	1,450	1,338	$198K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	3.6%	1,178	1,173	$169K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	2.6%	874	871	$126K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.6%	881	874	$125K
99308	Subsequent nursing facility care, per day, straightforward	<1%	761	739	$38K
99307		<1%	746	727	$26K
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	<1%	332	323	$25K
90686		<1%	666	658	$13K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	94	82	$5K
91307		<1%	94	92	$5K
99309	Subsequent nursing facility care, per day, low to moderate complexity	<1%	80	79	$4K

31 more codes

90651		<1%	256	$3K
0002A		<1%	66	$2K
0001A		<1%	51	$2K
90633		<1%	411	$850.65
90648		<1%	640	$424.34
90670		<1%	1,111	$285.52
90715		<1%	147	$285.52
90700		<1%	131	$283.55
90734		<1%	280	$281.58
91300		<1%	373	$281.58
0071A		<1%	12	$196.34
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	13	$145.76
90680		<1%	335	$142.76
90696		<1%	132	$140.79
90461		<1%	1,879	$23.52
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	5,937	$15.68
90698		0%	209	$0.00
92551		0%	1,436	$0.00
90716		0%	77	$0.00
90723		0%	334	$0.00
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	0%	27	$0.00
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	0%	648	$0.00
90474		0%	83	$0.00
90744		0%	14	$0.00
90619		0%	19	$0.00
99173		0%	1,431	$0.00
90472	Immunization administration, each additional vaccine (list separately)	0%	670	$0.00
90707		0%	73	$0.00
J1050	Injection, medroxyprogesterone acetate, 1 mg	0%	13	$0.00
90710		0%	135	$0.00
90672		0%	23	$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 officialRICHARDSON, KAREN (SR VP/CFO)