Medicaid Provider Spending

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

1366047748

NPI: 1366047748

Deactivated NPI · This NPI was deactivated on 11/12/2025.
$613K
Total Medicaid Paid
16,295
Total Claims
11,085
Beneficiaries
21
Codes Billed
2021-01
First Month
2024-12
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 2,256 $89K
2022 2,893 $87K
2023 2,641 $109K
2024 8,505 $328K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,039 2,471 $244K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,992 1,310 $93K
G0483 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; 22 or more drug class(es), including metabolite(s) if performed 678 455 $85K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 3,572 2,187 $57K
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 921 627 $44K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 740 556 $29K
90837 Psychotherapy, 53 minutes with patient 315 203 $22K
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 102 91 $8K
99199 Unlisted special service, procedure or report 2,436 2,258 $7K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 92 70 $6K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 635 393 $6K
99205 Prolong outpt/office vis 43 26 $4K
80305 445 233 $3K
90791 Psychiatric diagnostic evaluation 46 26 $2K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 71 55 $2K
99401 51 33 $499.74
80306 12 12 $222.12
96127 17 13 $50.51
81002 23 12 $27.76
Q9992 Injection, buprenorphine extended-release (sublocade), greater than 100 mg 50 41 $0.25
G0008 Administration of influenza virus vaccine 15 13 $0.00