Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › IA › SIOUX CITY › SIOUXLAND COMMUNITY HEALTH CENTER

SIOUXLAND COMMUNITY HEALTH CENTER

NPI: 1558355305 · SIOUX CITY, IA 51105 · Federally Qualified Health Center (FQHC) · NPI assigned 09/08/2005

$87.63M
Total Medicaid Paid
1,457,870
Total Claims
1,269,598
Beneficiaries
232
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPETERSON, CLARA (CFO)
NPI Enumeration Date09/08/2005

Related Entities

Other providers sharing the same authorized official: PETERSON, CLARA

ProviderCityStateTotal Paid
AMISTAD COMMUNITY HEALTH CENTER INCORPORATED CORPUS CHRISTI TX $10.40M
SIOUXLAND COMMUNITY HEALTH CENTER SOUTH SIOUX CITY NE $0.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 169,513 $10.00M
2019 176,393 $11.16M
2020 169,305 $10.89M
2021 212,717 $14.34M
2022 216,279 $14.44M
2023 251,804 $13.86M
2024 261,859 $12.95M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 283,643 232,367 $60.33M
D9999 Unspecified adjunctive procedure, by report 57,931 52,607 $12.40M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 186,557 154,342 $4.94M
D0999 Unspecified diagnostic procedure, by report 18,135 16,948 $4.59M
S0280 Medical home program, comprehensive care coordination and planning, initial plan 39,155 38,071 $1.59M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 64,289 58,854 $1.25M
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face 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 fqhc visit 20,100 17,133 $606K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 5,375 4,957 $242K
D1206 Topical application of fluoride varnish 44,375 41,456 $154K
D0120 Periodic oral evaluation - established patient 30,991 30,428 $129K
D1120 Prophylaxis - child 24,252 23,774 $128K
87428 12,780 12,156 $125K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 8,819 6,506 $86K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 25,352 24,337 $84K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 3,378 3,189 $75K
D1110 Prophylaxis - adult 14,210 13,914 $71K
D7140 Extraction, erupted tooth or exposed root 9,265 6,218 $57K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 7,211 6,879 $54K
D1351 Sealant - per tooth 26,618 8,234 $51K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2,162 2,021 $32K
36415 Collection of venous blood by venipuncture 50,289 47,224 $30K
D0150 Comprehensive oral evaluation - new or established patient 9,135 8,900 $29K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 6,469 6,354 $28K
D0274 Bitewings - four radiographic images 10,418 10,173 $28K
D0272 Bitewings - two radiographic images 11,926 11,677 $25K
87430 6,457 6,027 $25K
D0140 Limited oral evaluation - problem focused 10,587 10,294 $24K
D2391 Resin-based composite - one surface, posterior, primary or permanent 3,834 3,151 $22K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 436 417 $22K
D0330 Panoramic radiographic image 8,509 8,261 $22K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 3,754 3,642 $22K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 249 243 $21K
99309 Subsequent nursing facility care, per day, low to moderate complexity 1,914 1,785 $20K
D0210 Intraoral - complete series of radiographic images 2,471 2,416 $18K
D1999 73 67 $17K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 6,538 3,794 $16K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2,846 2,787 $14K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,224 2,171 $13K
2010F 11,881 9,878 $11K
D0220 Intraoral - periapical first radiographic image 14,897 14,329 $11K
80053 Comprehensive metabolic panel 14,845 14,322 $10K
83036 Hemoglobin; glycosylated (A1C) 18,220 17,735 $9K
81003 15,630 11,702 $9K
80061 Lipid panel 11,696 11,380 $7K
D0145 Oral evaluation for a patient under three years of age 4,356 4,278 $6K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 8,927 8,662 $6K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 4,652 4,283 $6K
D2930 Prefabricated stainless steel crown - primary tooth 683 574 $6K
3078F 9,184 7,719 $6K
84443 Thyroid stimulating hormone (TSH) 7,803 7,578 $5K
3074F 8,059 6,840 $5K
90834 Psychotherapy, 45 minutes with patient 1,473 1,088 $5K
96110 Developmental screening, with scoring and documentation, per standardized instrument 7,697 7,519 $5K
96127 2,781 2,573 $5K
80050 General health panel 2,850 2,769 $5K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 8,001 7,646 $5K
87276 1,792 1,728 $5K
94760 1,612 1,540 $4K
D2150 Silver amalgam - two surfaces, primary or permanent 533 370 $4K
90686 5,487 5,351 $4K
59430 232 214 $4K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 1,547 1,487 $4K
2000F 10,195 8,503 $4K
90837 Psychotherapy, 53 minutes with patient 1,059 664 $4K
87275 1,811 1,746 $4K
3044F 1,111 1,087 $3K
D0603 7,834 7,633 $3K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 5,676 4,742 $3K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 5,501 4,593 $3K
3075F 2,021 1,877 $3K
3079F 1,909 1,785 $3K
1036F 7,388 6,157 $2K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 206 182 $2K
D0240 2,116 1,584 $2K
81025 4,914 4,646 $2K
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 72 69 $2K
D1208 Topical application of fluoride, excluding varnish 721 705 $2K
3077F 1,492 1,375 $2K
85018 11,076 10,793 $2K
90792 Psychiatric diagnostic evaluation with medical services 636 615 $2K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 241 229 $2K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 3,718 3,435 $2K
90661 791 756 $2K
90472 Immunization administration, each additional vaccine (list separately) 2,358 1,849 $2K
99308 Subsequent nursing facility care, per day, straightforward 96 79 $1K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 1,111 1,096 $1K
87210 4,062 3,860 $1K
3008F 20,664 17,260 $1K
99238 Hospital discharge day management, 30 minutes or less 773 697 $1K
D0230 Intraoral - periapical each additional radiographic image 3,611 1,932 $1K
90460 Immunization administration through 18 years of age via any route, first or only component 17,531 7,798 $1K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 4,080 3,973 $1K
90677 1,239 1,184 $1K
99381 330 318 $1K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 409 394 $1K
J0561 Injection, penicillin g benzathine, 100,000 units 77 75 $940.40
2001F 11,533 9,623 $923.41
99000 2,590 2,497 $904.80
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1,731 1,685 $826.03
J1885 Injection, ketorolac tromethamine, per 15 mg 409 377 $772.92
D0602 3,907 3,795 $705.00
W0037 234 234 $702.00
3051F 148 146 $700.00
1159F 11,008 9,330 $671.54
99462 306 235 $665.46
36416 5,814 5,514 $648.49
3048F 327 320 $641.96
83655 2,071 2,030 $641.16
85027 2,433 2,366 $625.84
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 49 48 $616.16
71046 Radiologic examination, chest; 2 views 1,416 1,369 $607.92
99460 552 529 $441.76
90715 1,591 1,543 $370.67
86803 2,290 2,236 $356.75
86592 2,661 2,574 $347.55
90832 Psychotherapy, 30 minutes with patient 238 219 $329.43
84439 988 960 $314.82
90480 351 342 $310.12
81002 2,058 1,076 $301.52
3052F 75 75 $300.00
90474 179 172 $274.40
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 193 190 $263.61
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 851 690 $258.79
90791 Psychiatric diagnostic evaluation 221 209 $252.65
59025 Fetal non-stress test 1,733 645 $241.56
1125F 531 496 $223.12
3050F 113 112 $220.00
99318 44 33 $215.60
90461 5,020 3,960 $196.80
3049F 151 149 $160.00
92551 12 12 $158.02
90647 780 722 $152.88
99215 Prolong outpt/office vis 102 91 $149.61
99386 12 12 $149.61
87280 401 383 $147.62
81001 163 157 $130.36
82570 1,730 1,683 $128.43
82947 441 334 $128.43
82043 1,569 1,547 $128.43
87807 108 103 $124.75
D0270 202 191 $119.03
99173 85 83 $99.56
82950 750 712 $66.50
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 171 160 $66.48
73562 143 122 $47.91
80048 Basic metabolic panel (calcium, ionized) 596 582 $44.70
90723 1,028 983 $32.76
90680 625 588 $32.76
82607 750 737 $21.40
72100 37 37 $18.54
74019 51 51 $14.71
1160F 10,853 9,189 $3.29
J0696 Injection, ceftriaxone sodium, per 250 mg 28 25 $0.31
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 34 28 $0.18
1126F 636 555 $0.08
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 134 124 $0.07
J1050 Injection, medroxyprogesterone acetate, 1 mg 1,508 1,450 $0.00
90473 374 354 $0.00
90633 474 466 $0.00
85610 351 291 $0.00
0004A 62 62 $0.00
90710 115 111 $0.00
3046F 289 283 $0.00
4040F 1,451 1,244 $0.00
86318 135 128 $0.00
85014 330 315 $0.00
4274F 2,837 2,298 $0.00
90746 31 30 $0.00
86900 18 14 $0.00
87400 66 61 $0.00
D1354 33 15 $0.00
0124A 165 162 $0.00
90750 125 124 $0.00
91320 312 307 $0.00
90734 99 99 $0.00
4004F 1,273 1,187 $0.00
D2140 62 51 $0.00
90700 217 213 $0.00
90707 258 255 $0.00
0054A 13 13 $0.00
83540 25 24 $0.00
73630 12 12 $0.00
82565 66 65 $0.00
80074 28 28 $0.00
90713 12 12 $0.00
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) 22,817 22,537 $0.00
99439 3,439 3,409 $0.00
G2065 Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities 1,013 970 $0.00
90716 273 269 $0.00
4010F 1,513 1,335 $0.00
99426 420 417 $0.00
G9008 Coordinated care fee, physician coordinated care oversight services 5,762 5,651 $0.00
G2058 Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)). 648 583 $0.00
81000 759 711 $0.00
H0038 Self-help/peer services, per 15 minutes 2,418 2,395 $0.00
82951 155 152 $0.00
90651 182 182 $0.00
82728 104 101 $0.00
4037F 891 867 $0.00
90688 110 110 $0.00
S0281 Medical home program, comprehensive care coordination and planning, maintenance of plan 309 307 $0.00
99385 33 31 $0.00
3080F 692 647 $0.00
3352F 205 199 $0.00
0031A 57 56 $0.00
0134A 24 24 $0.00
86762 18 14 $0.00
3353F 71 69 $0.00
D0601 286 283 $0.00
1034F 2,317 1,998 $0.00
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 52 51 $0.00
99384 29 26 $0.00
0011A 96 95 $0.00
G0008 Administration of influenza virus vaccine 53 51 $0.00
87340 114 107 $0.00
3351F 1,772 1,590 $0.00
D1353 314 168 $0.00
0001A 61 61 $0.00
3061F 13 13 $0.00
92229 18 18 $0.00
90732 13 13 $0.00
82040 15 14 $0.00
99383 75 73 $0.00
90620 58 55 $0.00
90696 119 118 $0.00
93000 34 32 $0.00
90381 27 18 $0.00
86850 18 14 $0.00
99406 31 28 $0.00
86901 18 14 $0.00
87086 Culture, bacterial; quantitative colony count, urine 20 16 $0.00
0051A 12 12 $0.00