Medicaid Provider Spending

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

MARIA CARIDAD ILAR-REVILLA COMMUNITY HEALTH CLINIC LLC

NPI: 1386944437 · WAIPAHU, HI 96797 · Medical Specialty Clinic/Center · NPI assigned 10/22/2010

$242K
Total Medicaid Paid
37,230
Total Claims
34,637
Beneficiaries
40
Codes Billed
2018-01
First Month
2024-09
Last Month

Provider Details

Authorized OfficialILAR-REVILLA, MARIA (OWNER)
NPI Enumeration Date10/22/2010

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 7,061 $27K
2019 5,224 $25K
2020 3,880 $19K
2021 5,306 $35K
2022 6,534 $49K
2023 5,250 $39K
2024 3,975 $49K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6,673 6,082 $127K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,733 1,665 $61K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,987 1,861 $24K
80061 Lipid panel 3,406 3,350 $13K
90688 416 407 $3K
90756 300 298 $3K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 292 291 $2K
83036 Hemoglobin; glycosylated (A1C) 697 682 $2K
99397 196 195 $2K
82947 1,309 1,288 $1K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 140 70 $1K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 227 212 $840.64
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 84 84 $647.63
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 244 241 $388.23
G0008 Administration of influenza virus vaccine 339 332 $324.81
99441 22 20 $176.91
G9275 Documentation that patient is a current non-tobacco user 6,328 5,370 $79.89
93000 12 12 $56.80
3078F 2,763 2,600 $24.49
G0444 Annual depression screening, 5 to 15 minutes 68 67 $0.30
1159F 1,338 1,231 $0.00
1160F 1,405 1,286 $0.00
4040F 286 271 $0.00
3288F 517 495 $0.00
4274F 157 146 $0.00
2022F 30 30 $0.00
3044F 193 188 $0.00
1157F 422 415 $0.00
3075F 1,377 1,341 $0.00
1125F 63 61 $0.00
3074F 1,886 1,790 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 1,206 1,173 $0.00
1126F 190 186 $0.00
4010F 78 78 $0.00
3017F 48 47 $0.00
1170F 540 520 $0.00
3079F 149 147 $0.00
4037F 30 28 $0.00
1123F 67 65 $0.00
96127 12 12 $0.00