Medicaid Provider Spending

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

MCALLEN HOSPITALIST GROUP, PLLC

NPI: 1356361976 · EDINBURG, TX 78539 · Family Medicine Physician · NPI assigned 07/19/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official EVANS, TODD controls 20+ related entities in our dataset. Read more

$7.40M
Total Medicaid Paid
172,832
Total Claims
111,021
Beneficiaries
81
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialEVANS, TODD (VP)
NPI Enumeration Date07/19/2006

Related Entities

Other providers sharing the same authorized official: EVANS, TODD

ProviderCityStateTotal Paid
TEXOMACARE DENISON TX $5.95M
NORTHWEST TEXAS WYATT CLINIC PLLC AMARILLO TX $4.39M
NORTHERN NEVADA MEDICAL GROUP, LLC SPARKS NV $2.60M
TEXOMACARE MADILL OK $2.35M
MID ATLANTIC MEDICINE LLC WASHINGTON DC $1.84M
ST. MARY'S PHYSICIAN ASSOCIATES, LLC ENID OK $1.76M
LAS VEGAS MEDICAL GROUP LLC LAS VEGAS NV $1.36M
AIKEN PROFESSIONAL ASSOCIATION, LLC AIKEN SC $1.35M
NORTHWEST URGENT CARE, PLLC AMARILLO TX $1.02M
TEXOMACARE SPECIALTY PHYSICIANS DENISON TX $644K
EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC CLARION PA $636K
NWTX PHYSICIAN NETWORK, PLLC AMARILLO TX $475K
HEART CLINIC, PLLC MCALLEN TX $385K
LAREDO PHYSICIANS GROUP LAREDO TX $365K
NEVADA URGENT CARE NETWORK LLC SPARKS NV $211K
UHS OF DESERT SPRINGS, INC. HENDERSON NV $151K
MANATEE CARDIOLOGY ASSOCIATES, LLC BRADENTON FL $23K
WELLINGTON PHYSICIAN ALLIANCES INC WELLINGTON FL $14K
MANATEE PHYSICIAN ALLIANCE, LLC BRADENTON FL $14K
MARY ALICE COWAN, MD, PLLC HOUSTON TX $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12,683 $206K
2019 7,994 $134K
2020 9,376 $281K
2021 38,917 $1.62M
2022 37,190 $1.61M
2023 39,210 $1.99M
2024 27,462 $1.56M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99232 Subsequent hospital care, per day, moderate complexity 81,216 35,153 $3.02M
99238 Hospital discharge day management, 30 minutes or less 13,670 13,306 $671K
99223 Prolong inpt eval add15 m 5,417 5,141 $585K
99239 Hospital discharge day management, more than 30 minutes 6,439 6,047 $394K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 7,153 6,507 $387K
99222 Initial hospital care, per day, moderate complexity 3,930 3,847 $308K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,391 8,054 $285K
99231 Subsequent hospital care, per day, straightforward or low complexity 10,452 4,552 $263K
99233 Prolong inpt eval add15 m 7,416 2,956 $259K
99217 3,499 3,479 $188K
90791 Psychiatric diagnostic evaluation 1,545 1,466 $156K
99244 Office or other outpatient consultation, moderate to high complexity 1,109 1,097 $129K
99221 2,549 2,510 $113K
99219 1,259 1,255 $109K
44970 187 183 $82K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 728 698 $70K
99225 1,658 1,551 $65K
90837 Psychotherapy, 53 minutes with patient 720 294 $60K
99253 613 595 $47K
99215 Prolong outpt/office vis 280 247 $33K
99252 452 433 $28K
99218 402 399 $21K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 352 308 $21K
90834 Psychotherapy, 45 minutes with patient 274 124 $15K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 104 46 $15K
90832 Psychotherapy, 30 minutes with patient 175 52 $8K
99243 105 105 $8K
99254 56 55 $7K
76819 Fetal biophysical profile; without non-stress testing 94 55 $5K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 301 253 $5K
90792 Psychiatric diagnostic evaluation with medical services 44 39 $5K
99255 26 26 $4K
99245 27 26 $4K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 91 88 $4K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 85 24 $4K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 70 70 $3K
99205 Prolong outpt/office vis 49 43 $3K
99442 179 152 $3K
90674 159 140 $2K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 15 15 $2K
99224 72 71 $2K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 529 496 $1K
99220 12 12 $1K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 12 12 $987.61
90870 22 12 $985.44
81003 1,044 1,002 $698.59
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 85 79 $590.17
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 58 53 $307.33
83036 Hemoglobin; glycosylated (A1C) 94 89 $299.40
73562 14 12 $261.80
99443 34 32 $198.00
82043 41 40 $94.34
90756 47 40 $52.47
G0444 Annual depression screening, 5 to 15 minutes 46 41 $36.42
G0008 Administration of influenza virus vaccine 157 139 $33.67
36415 Collection of venous blood by venipuncture 4,506 4,167 $8.10
G8510 Screening for depression is documented as negative, a follow-up plan is not required 60 54 $0.04
1159F 205 187 $0.00
1160F 217 199 $0.00
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) 111 102 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 217 193 $0.00
3725F 239 219 $0.00
3078F 71 59 $0.00
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 12 12 $0.00
98968 73 56 $0.00
82947 27 25 $0.00
43246 13 12 $0.00
80061 Lipid panel 75 70 $0.00
3288F 30 25 $0.00
1036F 181 168 $0.00
3008F 198 181 $0.00
99024 1,305 1,128 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 16 13 $0.00
2000F 395 342 $0.00
1000F 188 181 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 28 25 $0.00
0503F 19 12 $0.00
82044 12 12 $0.00
3074F 45 33 $0.00
1101F 15 12 $0.00
1170F 16 13 $0.00