Medicaid Provider Spending

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

1508484726

NPI: 1508484726

OIG Excluded Provider · This provider appears on the HHS Office of Inspector General List of Excluded Individuals/Entities. Exclusion date: 06/20/2024.
Deactivated NPI · This NPI was deactivated on 04/01/2025.
$1.61M
Total Medicaid Paid
45,539
Total Claims
5,331
Beneficiaries
7
Codes Billed
2020-11
First Month
2023-02
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 4,114 $145K
2021 39,929 $1.46M
2022 729 $0.00
2023 767 $0.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90876 14,792 1,452 $1.26M
Q3014 Telehealth originating site facility fee 15,068 1,773 $188K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 14,550 1,439 $158K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 478 305 $0.00
90901 162 56 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 137 87 $0.00
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 352 219 $0.00