Medicaid Provider Spending

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

1386178044

NPI: 1386178044

Deactivated NPI · This NPI was deactivated on 11/12/2025.
$224K
Total Medicaid Paid
15,302
Total Claims
11,035
Beneficiaries
31
Codes Billed
2018-01
First Month
2023-07
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 2,720 $54K
2019 5,184 $89K
2020 3,524 $47K
2021 1,017 $13K
2022 2,209 $18K
2023 648 $4K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 2,724 1,996 $99K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 907 710 $35K
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 1,315 1,002 $15K
90460 Immunization administration through 18 years of age via any route, first or only component 304 201 $13K
96110 Developmental screening, with scoring and documentation, per standardized instrument 1,327 503 $12K
90791 Psychiatric diagnostic evaluation 140 114 $12K
3008F 2,246 1,763 $6K
90832 Psychotherapy, 30 minutes with patient 135 94 $6K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 45 28 $4K
T1015 Clinic visit/encounter, all-inclusive 21 17 $4K
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month 779 678 $4K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 36 16 $4K
36415 Collection of venous blood by venipuncture 1,899 1,397 $3K
3074F 885 699 $3K
3078F 752 605 $2K
92551 185 113 $2K
96150 65 46 $768.25
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 33 32 $581.70
3077F 113 102 $340.00
90688 43 33 $310.50
99173 78 57 $155.00
3079F 117 97 $150.00
81003 25 14 $35.14
3080F 15 14 $30.00
3075F 15 15 $10.00
99408 665 462 $3.48
4037F 108 81 $0.00
90651 34 15 $0.00
90686 53 34 $0.00
90620 12 12 $0.00
0502F 226 85 $0.00