Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › AZ › Tucson › NPI 1487602736
Clinic

El Rio Santa Cruz Neighborhood Health Center, INC

El Rio Santa Cruz Neighborhood Health Center, INC was paid $360.32M by Medicaid between Jan 2018 and Dec 2024, across 347 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.

33Billing provider infoEL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC
TUCSON, AZ 85745
33aNPI1487602736assigned 05/05/2006
28Total paid$360.32M
24GClaims4,351,444
24DCodes billed347
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Federally Qualified Health Center (FQHC) providers in Arizona

Rank by total paid#1 of 126
Median peer was paid$1.45M
This provider vs. median248×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official KUNTZ, CLINTON controls 15+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$5.0M$10M2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
2018613,374$40.25M
2019643,299$36.43M
2020368,929$29.03M
2021466,311$35.85M
2022765,662$64.50M
2023792,297$74.26M
2024incomplete701,572$80.02M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
T1015 A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive 99% 1,241,179 957,066 $357.76M
99214 Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity <1% 398,770 343,100 $472K
99238 Hospital discharge day management, 30 minutes or less <1% 5,622 5,509 $336K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) <1% 288 282 $240K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity <1% 406,359 349,683 $222K
99460 <1% 3,303 3,208 $214K
T1016 Case management, each 15 minutes <1% 16,664 12,768 $194K
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m <1% 3,403 1,295 $192K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 3,999 3,145 $130K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity <1% 2,644 1,067 $103K
99239 Hospital discharge day management, more than 30 minutes <1% 750 701 $38K
59514 <1% 26 26 $24K
335 more codes
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 123,559 $23K
99204 Doctor's office visit, new patient (more involved) <1% 5,310 $21K
H0031 Mental health assessment, by non-physician <1% 6,058 $21K
90837 Psychotherapy session, about an hour <1% 14,251 $20K
90750 <1% 7,338 $19K
99215 Doctor's office visit, returning patient (complex) <1% 10,556 $14K
90792 Psychiatric diagnostic evaluation with medical services <1% 3,670 $14K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 41,279 $14K
96156 <1% 17,171 $12K
90834 Psychotherapy session, about 45 minutes <1% 10,417 $10K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 20,045 $10K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 17,855 $9K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 30,581 $9K
H0004 Behavioral health counseling and therapy, per 15 minutes <1% 11,359 $8K
99385 <1% 2,845 $8K
99203 Doctor's office visit, new patient (routine) <1% 6,320 $8K
90686 <1% 60,336 $7K
0124A <1% 5,989 $6K
90670 <1% 20,883 $6K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 43,272 $6K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 60,332 $6K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 13,165 $5K
90715 <1% 19,562 $5K
99000 <1% 2,829 $5K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 30,169 $5K
90461 <1% 30,795 $4K
90791 Psychiatric diagnostic evaluation <1% 1,734 $4K
G0467 Community health center visit, returning patient <1% 14,600 $4K
99221 <1% 68 $4K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 20,464 $4K
97803 <1% 5,833 $3K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 4,687 $3K
0072A <1% 2,964 $3K
90472 Immunization administration, each additional vaccine (list separately) <1% 40,371 $3K
80061 Lipid panel <1% 6,751 $3K
90651 <1% 11,414 $3K
99381 <1% 3,945 $3K
97802 <1% 5,851 $2K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 3,354 $2K
0071A <1% 1,379 $2K
99223 Prolong inpt eval add15 m <1% 26 $2K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 3,353 $2K
99462 <1% 76 $2K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only <1% 2,515 $2K
77067 Screening mammography, bilateral, including computer-aided detection <1% 3,187 $2K
99386 <1% 1,215 $2K
36415 Collection of venous blood by venipuncture <1% 61,933 $2K
80053 Comprehensive metabolic panel <1% 6,060 $2K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 1,281 $2K
0012A <1% 1,914 $2K
90716 <1% 11,092 $2K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 457 $2K
99383 <1% 1,307 $2K
90734 <1% 6,536 $2K
90677 <1% 5,291 $2K
76830 Ultrasound, transvaginal <1% 1,068 $2K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 7,212 $1K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 10,964 $1K
96158 <1% 3,200 $1K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 3,653 $1K
90688 <1% 16,595 $1K
90620 <1% 5,900 $1K
96152 <1% 6,139 $1K
90732 <1% 827 $1K
H0038 Self-help/peer services, per 15 minutes <1% 735 $1K
83036 Hemoglobin; glycosylated (A1C) <1% 6,944 $1K
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 <1% 3,182 $1K
0011A <1% 1,914 $1K
99382 <1% 189 $1K
90723 <1% 15,250 $1K
99463 <1% 14 $1K
99384 <1% 644 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 8,552 $1K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 5,198 $1K
98927 <1% 373 $974.43
90707 <1% 10,687 $972.65
0001A <1% 3,719 $880.00
90746 <1% 1,211 $866.89
76642 <1% 1,099 $842.90
0054A <1% 1,008 $840.00
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 938 $828.71
90681 <1% 9,489 $815.56
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 377 $783.91
84443 Thyroid stimulating hormone (TSH) <1% 2,738 $696.97
77066 Tomosynthesis, mammo <1% 256 $690.05
0051A <1% 868 $680.00
80050 General health panel <1% 1,194 $666.36
71046 Radiologic examination, chest; 2 views <1% 4,036 $630.28
0004A <1% 4,590 $588.60
90647 <1% 20,192 $558.56
0002A <1% 3,530 $520.00
0052A <1% 19 $520.00
0031A <1% 514 $517.95
99441 <1% 106 $501.20
99442 <1% 186 $490.26
90632 <1% 424 $465.96
86803 <1% 1,946 $423.13
92227 <1% 1,470 $390.24
76536 <1% 37 $388.10
59025 Fetal non-stress test <1% 2,949 $378.57
J1050 Injection, medroxyprogesterone acetate, 1 mg <1% 3,287 $363.14
81003 <1% 23,438 $350.79
H2011 Crisis intervention service, per 15 minutes <1% 155 $347.40
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 712 $331.74
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 2,210 $325.96
91303 <1% 204 $317.95
77063 Screening digital breast tomosynthesis, bilateral <1% 3,379 $312.38
96167 <1% 92 $303.62
99244 Office or other outpatient consultation, moderate to high complexity <1% 139 $288.42
1159F <1% 95,217 $284.24
G0008 Administration of influenza virus vaccine <1% 4,245 $265.33
99177 <1% 27,810 $263.40
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth <1% 2,003 $232.88
90633 <1% 11,262 $219.00
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 70 $218.04
92551 <1% 30,468 $216.58
96154 <1% 4,813 $179.31
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit <1% 29 $171.98
82247 <1% 569 $169.69
D0140 Limited oral evaluation - problem focused <1% 16,152 $162.00
90832 Psychotherapy session, about 30 minutes <1% 2,886 $161.58
81025 <1% 16,194 $154.44
90853 Group psychotherapy (other than of a multiple-family group) <1% 38 $148.96
73564 <1% 197 $140.56
86592 <1% 2,009 $139.95
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit <1% 1,119 $134.60
82248 <1% 459 $129.87
90662 <1% 2,618 $124.00
99051 <1% 28,737 $115.22
36416 <1% 1,171 $104.10
73030 <1% 395 $103.88
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 307 $97.41
90696 <1% 3,345 $88.88
80048 Basic metabolic panel (calcium, ionized) <1% 2,285 $87.60
81001 <1% 2,312 $84.84
99173 <1% 23,113 $71.50
H0002 Behavioral health screening to determine eligibility for admission to treatment program <1% 228 $68.07
87088 <1% 1,671 $66.23
73630 <1% 128 $66.13
99397 <1% 511 $64.94
96150 <1% 2,132 $64.85
73610 <1% 31 $63.86
D0220 Intraoral - periapical first radiographic image <1% 18,483 $62.00
85610 <1% 2,052 $61.64
82962 <1% 2,915 $61.64
58300 <1% 1,359 $58.26
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 3,359 $53.42
86580 <1% 1,677 $46.18
87800 <1% 526 $45.57
93000 <1% 1,757 $44.70
20610 <1% 185 $34.30
90474 <1% 3,421 $31.07
82043 <1% 1,667 $26.80
86706 <1% 392 $25.40
84436 <1% 600 $23.81
87480 <1% 874 $23.71
87340 <1% 619 $22.50
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes <1% 346 $22.14
87070 <1% 1,155 $21.04
87186 <1% 480 $20.04
80076 <1% 387 $19.32
82728 <1% 477 $15.48
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 9,603 $14.88
85652 <1% 475 $9.63
83540 <1% 482 $7.35
82950 <1% 399 $5.61
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 1,205 $4.88
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 490 $1.35
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 916 $0.14
1036F <1% 311,568 $0.09
1220F <1% 134,296 $0.06
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg <1% 412 $0.04
96127 <1% 11,052 $0.02
1158F <1% 14,019 $0.01
1003F <1% 1,585 $0.01
91300 <1% 7,635 $0.01
1125F <1% 27,478 $0.01
1101F <1% 5,375 $0.01
1126F <1% 30,272 $0.01
1157F <1% 7,926 $0.01
91320 0% 5,659 $0.00
90682 0% 332 $0.00
3077F 0% 11,715 $0.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 0% 989 $0.00
D2930 Prefabricated stainless steel crown - primary tooth 0% 1,524 $0.00
90713 0% 1,835 $0.00
87481 0% 138 $0.00
84460 0% 131 $0.00
91312 0% 3,585 $0.00
D0190 0% 15,379 $0.00
D0330 Panoramic radiographic image 0% 2,968 $0.00
3078F 0% 24,738 $0.00
90473 0% 1,620 $0.00
1160F 0% 26,721 $0.00
D0274 Bitewings - four radiographic images 0% 3,114 $0.00
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 0% 113 $0.00
11982 0% 167 $0.00
2028F 0% 750 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 0% 2,638 $0.00
D1120 Dental cleaning, child 0% 11,859 $0.00
86705 0% 182 $0.00
G0470 Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit 0% 477 $0.00
98968 0% 538 $0.00
97161 0% 1,121 $0.00
90700 0% 5,459 $0.00
D0270 0% 4,054 $0.00
91308 0% 660 $0.00
4004F 0% 1,264 $0.00
80305 0% 207 $0.00
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 0% 726 $0.00
81002 0% 7,019 $0.00
2024F 0% 1,348 $0.00
96153 0% 632 $0.00
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 0% 2,275 $0.00
D1110 Prophylaxis - adult 0% 2,479 $0.00
90678 0% 77 $0.00
87660 0% 789 $0.00
1090F 0% 95 $0.00
G0468 Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv 0% 357 $0.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 0% 2,078 $0.00
D0145 Oral evaluation for a patient under three years of age 0% 946 $0.00
D1354 0% 4,384 $0.00
11981 0% 498 $0.00
0003A 0% 180 $0.00
1100F 0% 152 $0.00
72100 0% 258 $0.00
90685 0% 1,175 $0.00
70355 0% 53 $0.00
90648 0% 103 $0.00
3046F 0% 140 $0.00
77062 0% 132 $0.00
3051F 0% 76 $0.00
84450 0% 118 $0.00
73130 0% 28 $0.00
0073A 0% 35 $0.00
0502F 0% 212 $0.00
G0466 Community health center visit, new patient 0% 61 $0.00
82947 0% 74 $0.00
73562 0% 45 $0.00
J7297 Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg 0% 51 $0.00
77065 Tomosynthesis, mammo 0% 59 $0.00
99201 0% 85 $0.00
80074 0% 13 $0.00
0053A 0% 147 $0.00
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 0% 27 $0.00
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 0% 124 $0.00
87210 0% 32 $0.00
86431 0% 174 $0.00
82565 0% 12 $0.00
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) 0% 13 $0.00
4040F 0% 17 $0.00
73110 0% 14 $0.00
95004 Percutaneous tests with allergenic extracts, immediate type reaction 0% 49 $0.00
76770 0% 16 $0.00
84550 0% 14 $0.00
82570 0% 14 $0.00
98926 0% 30 $0.00
D2740 Crown - porcelain/ceramic 0% 23 $0.00
97039 0% 19 $0.00
92228 0% 671 $0.00
D0272 Bitewings - two radiographic images 0% 6,941 $0.00
D1206 Topical application of fluoride varnish 0% 24,664 $0.00
D0230 Intraoral - periapical each additional radiographic image 0% 3,798 $0.00
3075F 0% 12,972 $0.00
3074F 0% 24,588 $0.00
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 0% 99 $0.00
90480 0% 8,378 $0.00
58100 0% 360 $0.00
D0150 Comprehensive oral evaluation - new or established patient 0% 2,910 $0.00
0154A 0% 559 $0.00
3079F 0% 18,447 $0.00
D0120 Dental checkup, returning patient 0% 9,929 $0.00
D0603 0% 1,529 $0.00
91301 0% 997 $0.00
90619 0% 1,080 $0.00
90656 0% 5,092 $0.00
D0240 0% 5,010 $0.00
3080F 0% 5,203 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 0% 1,980 $0.00
D7140 Extraction, erupted tooth or exposed root 0% 8,285 $0.00
0081A 0% 579 $0.00
91319 0% 147 $0.00
87081 0% 1,149 $0.00
D1351 Sealant - per tooth 0% 6,346 $0.00
99417 Prolong home eval add 15m 0% 241 $0.00
88720 0% 609 $0.00
D1310 0% 2,125 $0.00
96151 0% 130 $0.00
98967 0% 56 $0.00
90674 0% 15 $0.00
91315 0% 187 $0.00
91307 0% 2,901 $0.00
D1330 0% 2,182 $0.00
97162 0% 151 $0.00
87807 0% 125 $0.00
G0009 Administration of pneumococcal vaccine 0% 331 $0.00
58301 0% 265 $0.00
0082A 0% 397 $0.00
91305 0% 718 $0.00
87510 0% 765 $0.00
3044F 0% 186 $0.00
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 0% 38 $0.00
83735 0% 220 $0.00
94010 0% 47 $0.00
76801 0% 398 $0.00
85027 0% 93 $0.00
84153 0% 104 $0.00
96164 0% 87 $0.00
3008F 0% 399 $0.00
90739 0% 302 $0.00
83550 0% 185 $0.00
80055 0% 177 $0.00
4037F 0% 92 $0.00
87511 0% 152 $0.00
83001 0% 51 $0.00
90744 0% 30 $0.00
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 0% 568 $0.00
0173A 0% 124 $0.00
57454 0% 96 $0.00
80081 0% 175 $0.00
D0602 0% 197 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 0% 39 $0.00
91318 0% 72 $0.00
90847 Family psychotherapy with the patient present, 50 minutes 0% 33 $0.00
3052F 0% 17 $0.00
D0210 Intraoral - complete series of radiographic images 0% 104 $0.00
82550 0% 14 $0.00
D0601 0% 198 $0.00
97016 0% 12 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 0% 31 $0.00
82150 0% 12 $0.00
96161 0% 12 $0.00
73502 0% 15 $0.00
97014 0% 19 $0.00
82040 0% 13 $0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

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Authorized officialKUNTZ, CLINTON (CEO)
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