Medicaid Provider Spending

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

KAISER FOUNDATION HEALTH PLAN INC

NPI: 1407862030 · HONOLULU, HI 96813 · Health Maintenance Organization · NPI assigned 08/01/2006

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

Authorized official ADAMS, JAMES controls 12+ related entities in our dataset. Read more

$7.37M
Total Medicaid Paid
112,592
Total Claims
99,351
Beneficiaries
76
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialADAMS, JAMES (EXECUTIVE DIRECTOR, FINANCE LEADER)
NPI Enumeration Date08/01/2006

Related Entities

Other providers sharing the same authorized official: ADAMS, JAMES

ProviderCityStateTotal Paid
VILLAGE OF BROOKFIELD BROOKFIELD IL $1.54M
MEDTECH LABORATORY SERVICES LLC CYPRESS TX $852K
KAISER FOUNDATION HEALTH PLAN INC KAPOLEI HI $631K
KAISER FOUNDATION HEALTH PLAN INC HONOLULU HI $499K
CITY OF CANTON CANTON OH $326K
KAISER FOUNDATION HEALTH PLAN HONOLULU HI $248K
KAISER FOUNDATION HEALTH PLAN INC WAIPAHU HI $246K
VEGAS HOSPITAL CARE LLC LAS VEGAS NV $54K
KAISER FOUNDATION HEALTH PLAN INC KANEOHE HI $28K
KAISER FOUNDATION HEALTH PLAN INC LAHAINA HI $8K
KAISER FOUNDATION HEALTH PLAN INC WAILUKU HI $4K
KAISER FOUNDATION HEALTH PLAN INC KIHEI HI $3K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 20,093 $1.89M
2019 20,026 $2.08M
2020 15,509 $541K
2021 14,025 $691K
2022 26,249 $881K
2023 9,979 $645K
2024 6,711 $638K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90837 Psychotherapy, 53 minutes with patient 7,837 6,343 $2.05M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 12,875 9,278 $1.61M
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 5,372 4,651 $643K
90834 Psychotherapy, 45 minutes with patient 2,499 2,047 $503K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 10,564 9,939 $287K
81001 15,336 14,562 $217K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,531 1,292 $162K
98968 2,208 1,841 $161K
81025 4,594 4,497 $134K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 513 437 $131K
80051 4,458 4,244 $128K
82565 6,584 6,273 $116K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,909 803 $115K
92523 179 179 $106K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 966 935 $74K
97161 438 431 $70K
85027 3,244 3,072 $62K
97530 Therapeutic activities, direct patient contact, each 15 minutes 177 102 $62K
84460 3,180 3,058 $58K
84450 2,864 2,749 $50K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 830 819 $50K
85610 3,285 2,536 $49K
92557 571 558 $44K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 269 261 $42K
84520 3,207 3,072 $41K
82247 1,785 1,495 $38K
92567 1,078 1,061 $38K
82947 2,597 2,499 $33K
84075 1,594 1,537 $28K
84484 594 572 $28K
83690 1,089 1,045 $25K
99215 Prolong outpt/office vis 62 62 $20K
92593 195 178 $14K
88720 1,305 1,139 $14K
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 142 121 $13K
99199 Unlisted special service, procedure or report 524 162 $13K
81003 1,552 1,519 $12K
81002 916 658 $12K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 29 29 $9K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 69 50 $8K
99386 25 25 $8K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 53 52 $8K
81000 558 527 $7K
99441 160 150 $7K
97150 Therapeutic procedure(s), group (2 or more individuals) 149 100 $7K
98962 50 24 $6K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 16 16 $5K
90832 Psychotherapy, 30 minutes with patient 54 38 $5K
85652 458 446 $5K
99443 56 52 $5K
85007 627 544 $5K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 219 217 $4K
85730 253 247 $4K
77080 63 62 $3K
97165 15 15 $3K
99078 30 13 $2K
82150 68 66 $2K
99350 Prolong home eval add 15m 36 26 $2K
90853 Group psychotherapy (other than of a multiple-family group) 46 26 $2K
99309 Subsequent nursing facility care, per day, low to moderate complexity 60 40 $2K
97804 12 12 $2K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 14 14 $1K
92558 49 48 $1K
90686 164 162 $787.50
99442 12 12 $730.87
85379 85 84 $728.04
98966 18 15 $588.00
99417 Prolong home eval add 15m 15 13 $496.00
85018 28 28 $461.50
85014 28 28 $461.50
S9999 Sales tax 20 14 $32.27
99385 44 44 $0.00
99205 Prolong outpt/office vis 12 12 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 48 48 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 13 12 $0.00
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment 13 13 $0.00