Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NH › LEBANON › DARTMOUTH-HITCHCOCK CLINIC

DARTMOUTH-HITCHCOCK CLINIC

NPI: 1548210198 · LEBANON, NH 03756 · Pediatrics Physician · NPI assigned 05/12/2006

$31.39M
Total Medicaid Paid
978,576
Total Claims
811,641
Beneficiaries
315
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialJANTZEN, DANIEL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date05/12/2006

Related Entities

Other providers sharing the same authorized official: JANTZEN, DANIEL

ProviderCityStateTotal Paid
MARY HITCHCOCK MEMORIAL HOSPITAL LEBANON NH $32.31M
DARTMOUTH-HITCHCOCK CLINIC KEENE NH $606K
DARTMOUTH-HITCHCOCK CLINIC LEBANON NH $93K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 170,350 $4.76M
2019 174,403 $5.34M
2020 133,503 $4.10M
2021 157,964 $5.19M
2022 162,641 $5.76M
2023 115,272 $4.10M
2024 64,443 $2.13M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 175,299 149,947 $9.11M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 97,659 87,069 $3.48M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 21,112 18,773 $1.70M
88305 Level IV - Surgical pathology, gross and microscopic examination 41,669 37,073 $1.38M
99233 Prolong inpt eval add15 m 23,093 7,089 $870K
99284 Emergency department visit for the evaluation and management, high severity 13,781 12,604 $771K
74177 Computed tomography, abdomen and pelvis; with contrast material 16,493 14,771 $689K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 7,901 1,148 $618K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 9,387 8,799 $588K
D7240 Removal of impacted tooth - completely bony 2,005 847 $581K
99244 Office or other outpatient consultation, moderate to high complexity 6,672 6,321 $552K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 6,457 5,739 $537K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 8,458 7,609 $521K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 12,923 11,467 $490K
70450 Computed tomography, head or brain; without contrast material 21,618 18,159 $476K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 7,485 7,205 $466K
J0585 Injection, onabotulinumtoxina, 1 unit 1,146 600 $458K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 97,372 75,765 $453K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 5,191 4,628 $442K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 3,074 2,829 $406K
99215 Prolong outpt/office vis 5,466 4,770 $300K
99232 Subsequent hospital care, per day, moderate complexity 10,226 3,265 $240K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 45,346 42,723 $231K
77067 Screening mammography, bilateral, including computer-aided detection 5,692 5,499 $229K
71046 Radiologic examination, chest; 2 views 32,813 28,737 $222K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 5,048 4,545 $179K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 6,054 5,013 $177K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,478 2,387 $154K
71045 Radiologic examination, chest; single view 39,942 29,464 $147K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 809 763 $146K
45380 Colonoscopy, flexible; with biopsy, single or multiple 781 713 $143K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 2,148 707 $142K
99309 Subsequent nursing facility care, per day, low to moderate complexity 13,299 7,368 $140K
70551 Magnetic resonance imaging, brain; without contrast material 2,757 2,466 $135K
95720 1,487 587 $132K
99223 Prolong inpt eval add15 m 1,625 1,352 $118K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 875 774 $117K
77063 Screening digital breast tomosynthesis, bilateral 5,386 5,250 $116K
88307 3,595 3,204 $116K
99243 1,809 1,635 $113K
90472 Immunization administration, each additional vaccine (list separately) 18,134 17,098 $103K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 1,391 1,241 $98K
90834 Psychotherapy, 45 minutes with patient 1,726 941 $95K
78815 Positron emission tomography (PET) for limited area imaging 1,236 1,125 $91K
99479 Subsequent intensive care, per day, very low birth weight infant 1,125 235 $86K
74018 9,641 8,106 $82K
99480 Subsequent intensive care, per day, low birth weight infant 1,151 256 $80K
99239 Hospital discharge day management, more than 30 minutes 1,681 1,444 $79K
93325 5,916 5,112 $74K
71260 Computed tomography, thorax, diagnostic; with contrast material 2,406 2,160 $72K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 1,310 1,011 $67K
93000 5,549 4,858 $66K
76770 2,856 2,641 $64K
99245 534 523 $63K
95951 750 274 $60K
76705 Ultrasound, abdominal, real time with image documentation; limited 3,339 3,087 $58K
90853 Group psychotherapy (other than of a multiple-family group) 3,604 1,781 $58K
G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician 2,814 2,667 $56K
76830 Ultrasound, transvaginal 1,644 1,543 $55K
67028 Intravitreal injection of a pharmacologic agent 1,310 1,072 $50K
99205 Prolong outpt/office vis 687 663 $48K
42820 Tonsillectomy and adenoidectomy; younger than age 12 187 182 $47K
00170 Anesthesia for intraoral procedures, including biopsy 574 532 $46K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,032 1,716 $45K
72125 Computed tomography, cervical spine; without contrast material 1,731 1,504 $44K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 818 774 $44K
99238 Hospital discharge day management, 30 minutes or less 886 816 $43K
76825 741 638 $42K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 1,930 1,568 $42K
99460 952 851 $42K
D9239 316 289 $41K
71275 Computed tomographic angiography, chest, with contrast material 972 877 $41K
92567 5,444 5,112 $41K
93320 1,337 1,197 $39K
94010 4,022 3,725 $36K
D9243 296 271 $36K
71250 1,319 1,190 $35K
93922 1,564 1,316 $35K
76700 Ultrasound, abdominal, real time with image documentation; complete 583 519 $34K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 1,141 915 $34K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger 148 24 $32K
93971 1,031 892 $32K
99242 679 645 $30K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 677 622 $28K
74176 Computed tomography, abdomen and pelvis; without contrast material 731 647 $27K
99173 5,387 5,181 $27K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 133 114 $26K
51741 751 599 $26K
76827 741 638 $25K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,405 1,016 $25K
73630 4,587 3,945 $24K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 451 360 $24K
01922 192 188 $23K
92558 1,621 1,548 $22K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 450 409 $22K
99308 Subsequent nursing facility care, per day, straightforward 2,993 1,440 $22K
90686 19,040 18,097 $21K
95810 Polysomnography; sleep staging with 4 or more additional parameters 439 387 $21K
74183 315 290 $20K
95117 2,863 1,691 $20K
D7230 93 70 $19K
92015 Determination of refractive state 1,464 1,210 $18K
90832 Psychotherapy, 30 minutes with patient 515 339 $18K
64615 293 275 $18K
73610 3,316 2,990 $17K
99310 Prolong nursin fac eval 15m 1,120 656 $17K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,841 1,704 $16K
20610 1,013 787 $16K
93970 599 499 $16K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 41 40 $15K
95886 337 297 $15K
99231 Subsequent hospital care, per day, straightforward or low complexity 877 319 $14K
D7140 Extraction, erupted tooth or exposed root 257 41 $12K
85060 1,684 1,321 $12K
73030 2,504 2,184 $12K
77002 1,058 980 $12K
88342 1,010 856 $12K
90792 Psychiatric diagnostic evaluation with medical services 226 189 $12K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 168 150 $12K
90870 368 130 $12K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 482 424 $12K
95953 114 82 $11K
90460 Immunization administration through 18 years of age via any route, first or only component 2,003 1,700 $11K
0071A 411 376 $11K
83036 Hemoglobin; glycosylated (A1C) 1,560 1,439 $10K
0072A 367 351 $10K
88112 730 584 $10K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 399 287 $10K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 302 260 $10K
73110 1,843 1,619 $9K
88173 245 165 $9K
72100 1,092 1,001 $8K
88304 911 837 $8K
93880 135 119 $7K
73130 1,428 1,179 $7K
51798 838 652 $7K
76642 253 231 $7K
G0444 Annual depression screening, 5 to 15 minutes 1,026 1,005 $7K
54150 102 93 $7K
0001A 179 178 $7K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 504 393 $6K
73564 726 630 $6K
A9575 Injection, gadoterate meglumine, 0.1 ml 920 800 $6K
76819 Fetal biophysical profile; without non-stress testing 180 120 $6K
90837 Psychotherapy, 53 minutes with patient 65 37 $6K
0002A 145 143 $6K
73502 1,016 911 $5K
73221 138 130 $5K
31575 122 109 $5K
99177 335 321 $5K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 91 78 $5K
96110 Developmental screening, with scoring and documentation, per standardized instrument 870 779 $5K
11721 679 463 $4K
H0015 Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education 55 19 $4K
88188 141 112 $4K
92557 164 164 $4K
73560 955 801 $4K
92551 759 696 $4K
81002 2,191 1,867 $4K
72141 88 77 $4K
92587 129 126 $4K
D7220 13 12 $4K
93294 465 387 $3K
94729 921 846 $3K
0054A 114 103 $3K
92579 208 189 $3K
00731 69 67 $3K
83655 359 312 $3K
73522 319 296 $3K
A4627 Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler 161 153 $3K
99443 369 255 $3K
71271 34 33 $3K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 169 157 $3K
93321 594 506 $3K
90474 942 879 $3K
76801 75 66 $3K
93295 134 125 $3K
J7050 Infusion, normal saline solution, 250 cc 1,585 984 $3K
0004A 113 99 $3K
99282 Emergency department visit for the evaluation and management, low to moderate severity 111 107 $3K
90961 49 42 $3K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 65 63 $3K
77072 386 373 $3K
72082 254 240 $3K
95718 38 26 $2K
95816 85 79 $2K
95911 27 24 $2K
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 109 83 $2K
99222 Initial hospital care, per day, moderate complexity 51 39 $2K
99152 403 350 $2K
94060 101 94 $2K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 71 63 $2K
77014 73 13 $2K
97802 44 39 $2K
99335 48 37 $2K
93016 186 167 $2K
0064A 62 61 $2K
99283 Emergency department visit for the evaluation and management, moderate severity 42 40 $2K
95806 26 26 $2K
93018 186 167 $1K
73562 281 250 $1K
95708 16 12 $1K
73080 282 245 $1K
0052A 51 45 $1K
59025 Fetal non-stress test 90 69 $1K
0124A 52 52 $1K
74019 180 162 $1K
99381 34 29 $1K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 43 39 $1K
95115 179 115 $1K
70496 27 24 $1K
72081 126 122 $1K
96127 318 289 $1K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 218 183 $1K
91065 114 77 $1K
72040 169 155 $1K
76942 71 65 $971.32
95819 44 37 $949.85
93248 46 41 $946.70
90461 292 207 $938.15
62323 14 13 $800.62
76813 17 12 $795.00
95782 12 12 $753.86
93304 32 29 $748.84
88311 126 104 $735.80
73700 27 24 $723.46
70491 15 13 $707.38
72131 26 25 $703.03
70486 26 25 $654.72
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 15 12 $633.08
76857 37 36 $632.16
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 85 77 $631.95
95700 17 13 $626.26
85018 342 308 $624.00
99241 22 19 $621.82
76536 15 12 $608.81
99188 164 153 $606.56
70498 13 12 $529.21
99221 15 13 $524.46
73590 117 102 $522.48
99358 Prolong nursin fac eval 15m 20 16 $522.28
99462 20 15 $521.12
0298T 33 27 $513.53
17110 35 28 $472.83
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 31 26 $439.14
88108 53 38 $438.55
95719 16 12 $423.36
88302 72 66 $421.69
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 55 52 $412.67
00104 23 13 $412.01
77066 Tomosynthesis, mammo 14 12 $408.17
76499 32 27 $388.49
88341 14 12 $373.45
0003A 13 12 $360.14
96161 242 235 $325.16
85097 13 12 $324.68
82962 349 281 $320.64
85390 43 38 $317.36
73140 73 69 $316.02
0081A 12 12 $302.60
86334 28 25 $294.92
11719 78 63 $290.27
92555 56 55 $271.13
88300 101 89 $262.29
99201 15 12 $247.92
92504 16 13 $247.36
11720 44 28 $239.42
84165 28 25 $226.24
93227 12 12 $223.13
88312 14 12 $213.93
99348 97 42 $207.96
88313 19 13 $207.33
96375 Therapeutic injection; each additional sequential IV push 17 12 $189.74
93298 12 12 $183.98
80305 20 12 $170.38
90651 142 135 $166.82
90670 4,166 3,863 $140.22
G0127 Trimming of dystrophic nails, any number 62 57 $136.11
64405 15 12 $122.54
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 46 39 $100.59
69210 17 13 $96.13
99347 30 13 $91.83
82947 49 41 $76.91
73090 13 12 $72.78
93246 13 12 $58.92
94726 15 14 $51.45
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 13 12 $4.43
G0008 Administration of influenza virus vaccine 58 31 $1.96
91307 843 769 $0.71
91305 277 249 $0.20
91300 520 471 $0.17
91312 52 52 $0.09
91308 35 31 $0.05
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 186 157 $0.05
91306 62 61 $0.02
90698 1,991 1,830 $0.01
90633 1,102 1,025 $0.00
90648 1,188 1,111 $0.00
90685 411 378 $0.00
90710 28 27 $0.00
90734 81 79 $0.00
90681 157 146 $0.00
90707 28 27 $0.00
G8918 Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis 16 13 $0.00
G8907 Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility 16 13 $0.00
90715 15 13 $0.00
90680 906 843 $0.00
90744 241 216 $0.00
90696 28 27 $0.00
90723 735 694 $0.00
90697 211 209 $0.00
90716 26 25 $0.00
99140 16 13 $0.00
90619 12 12 $0.00
96040 12 12 $0.00