Medicaid Provider Spending

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

RHEUMATOLOGY AND PULMONARY CLINIC PLLC

NPI: 1467439463 · BECKLEY, WV 25801 · Specialist · NPI assigned 12/30/2005

$631K
Total Medicaid Paid
31,314
Total Claims
26,782
Beneficiaries
47
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialFONDALE, BECKY (OFFICE MANAGER)
NPI Enumeration Date12/30/2005

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 13,764 $206K
2019 1,885 $57K
2020 3,414 $81K
2021 2,965 $64K
2022 2,103 $59K
2023 3,740 $90K
2024 3,443 $74K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6,975 6,259 $174K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,449 3,519 $165K
99232 Subsequent hospital care, per day, moderate complexity 2,133 732 $75K
94726 1,328 1,186 $18K
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 1,458 1,374 $17K
94729 1,334 1,184 $17K
94060 1,318 1,179 $16K
71046 Radiologic examination, chest; 2 views 1,511 1,256 $13K
G8730 Pain assessment documented as positive using a standardized tool and a follow-up plan is documented 928 880 $12K
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 843 805 $10K
20610 218 158 $9K
1006F 570 544 $8K
G9716 Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason 410 390 $6K
G8420 Bmi is documented within normal parameters and no follow-up plan is required 507 473 $6K
4004F 552 513 $5K
G8783 Normal blood pressure reading documented, follow-up not required 540 502 $5K
G8752 Most recent systolic blood pressure < 140 mmhg 547 507 $5K
G8754 Most recent diastolic blood pressure < 90 mmhg 551 513 $5K
95810 Polysomnography; sleep staging with 4 or more additional parameters 130 122 $5K
1170F 370 353 $5K
G8731 Pain assessment using a standardized tool is documented as negative, no follow-up plan required 353 336 $4K
3023F 456 423 $4K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 68 66 $4K
1036F 370 344 $4K
99442 388 360 $3K
4040F 422 394 $3K
G8482 Influenza immunization administered or previously received 408 382 $3K
3455F 251 237 $3K
4192F 215 205 $3K
G9695 Long-acting inhaled bronchodilator prescribed 333 310 $3K
3475F 253 243 $2K
99222 Initial hospital care, per day, moderate complexity 54 53 $2K
95811 63 60 $2K
3470F 196 187 $2K
99441 258 220 $1K
99223 Prolong inpt eval add15 m 31 29 $1K
3476F 62 55 $1K
99231 Subsequent hospital care, per day, straightforward or low complexity 31 12 $1K
4193F 92 90 $1K
3471F 59 59 $1K
G8399 Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed 127 122 $1K
J1030 Injection, methylprednisolone acetate, 40 mg 27 27 $1K
99221 15 14 $1K
0540F 60 58 $828.42
99233 Prolong inpt eval add15 m 21 21 $750.60
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 13 13 $275.00
77080 16 13 $0.00