Medicaid Provider Spending

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

METRO COMMUNITY PROVIDER NETWORK INC

NPI: 1558727883 · AURORA, CO 80010 · Federally Qualified Health Center (FQHC) · NPI assigned 12/31/2015

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official PEER, APRIL controls 18+ related entities in our dataset. Read more

$11.08M
Total Medicaid Paid
100,582
Total Claims
86,652
Beneficiaries
116
Codes Billed
2018-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialPEER, APRIL (CFO)
Parent OrganizationMETRO COMMUNITY PROVIDER NETWORK INC
NPI Enumeration Date12/31/2015

Related Entities

Other providers sharing the same authorized official: PEER, APRIL

ProviderCityStateTotal Paid
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $25.62M
METRO COMMUNITY PROVIDER NETWORK INC WHEAT RIDGE CO $23.59M
METRO COMMUNITY PROVIDER NETWORK, INC. AURORA CO $9.74M
METRO COMMUNITY PROVIDER NETWORK INC ARVADA CO $9.29M
METRO COMMUNITY PROVIDER NETWORK INC PARKER CO $3.84M
METRO COMMUNITY PROVIDER NETWORK, INC. ENGLEWOOD CO $3.24M
METRO COMMUNITY PROVIDER NETWORK INC LAKEWOOD CO $3.14M
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $1.35M
METRO COMMUNITY PROVIDER NETWORK, INC. AURORA CO $928K
METRO COMMUNITY PROVIDER NETWORK INC LAKEWOOD CO $865K
METRO COMMUNITY PROVIDER NETWORK, INC. LAKEWOOD CO $560K
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $468K
METRO COMMUNITY PROVIDER NETWORK, INC. GOLDEN CO $464K
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $358K
METRO COMMUNITY PROVIDER NETWORK INC CONIFER CO $241K
METRO COMMUNITY PROVIDER NETWORK INC AURORA CO $59K
METRO COMMUNITY PROVIDER NETWORK, INC. AURORA CO $49K
METRO COMMUNITY PROVIDER NETWORK INC WHEAT RIDGE CO $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 9,887 $752K
2019 17,620 $1.35M
2020 16,636 $1.63M
2021 14,084 $1.84M
2022 19,363 $2.32M
2023 18,589 $2.58M
2024 4,403 $612K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 21,650 18,309 $4.12M
D0999 Unspecified diagnostic procedure, by report 10,462 8,794 $2.30M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 11,335 9,785 $2.07M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,880 2,580 $550K
H0002 Behavioral health screening to determine eligibility for admission to treatment program 3,416 1,848 $441K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,836 1,652 $332K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,232 1,164 $228K
90460 Immunization administration through 18 years of age via any route, first or only component 3,231 2,831 $186K
99215 Prolong outpt/office vis 979 817 $162K
99201 643 580 $112K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 399 371 $78K
H0031 Mental health assessment, by non-physician 531 278 $70K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 551 418 $67K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 304 290 $60K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 253 240 $53K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 5,526 5,126 $52K
90832 Psychotherapy, 30 minutes with patient 315 214 $36K
H0023 Behavioral health outreach service (planned approach to reach a targeted population) 157 66 $21K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 115 100 $20K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 104 102 $19K
D1206 Topical application of fluoride varnish 1,862 1,609 $16K
D0150 Comprehensive oral evaluation - new or established patient 675 566 $12K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 130 82 $10K
D0220 Intraoral - periapical first radiographic image 2,668 2,501 $7K
D2391 Resin-based composite - one surface, posterior, primary or permanent 124 64 $7K
D0120 Periodic oral evaluation - established patient 1,316 1,264 $6K
D0230 Intraoral - periapical each additional radiographic image 1,779 1,692 $4K
D1120 Prophylaxis - child 444 416 $4K
99442 13 13 $3K
D7140 Extraction, erupted tooth or exposed root 95 52 $3K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,023 837 $3K
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 106 93 $3K
0004A 77 73 $3K
D0140 Limited oral evaluation - problem focused 387 370 $2K
90480 30 30 $2K
D0274 Bitewings - four radiographic images 305 286 $2K
0124A 59 48 $2K
D0210 Intraoral - complete series of radiographic images 24 13 $2K
D0272 Bitewings - two radiographic images 281 275 $1K
D1110 Prophylaxis - adult 85 84 $1K
0081A 33 31 $1K
D1351 Sealant - per tooth 96 25 $1K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 95 69 $1K
D0145 Oral evaluation for a patient under three years of age 101 91 $806.00
0173A 13 13 $535.34
0064A 12 12 $452.98
D0180 56 54 $443.12
90649 81 76 $421.96
D0330 Panoramic radiographic image 84 84 $333.00
86769 104 87 $310.38
G8510 Screening for depression is documented as negative, a follow-up plan is not required 1,154 1,083 $298.49
91320 14 13 $286.73
99173 1,026 949 $249.97
90686 2,462 2,311 $108.88
D1208 Topical application of fluoride, excluding varnish 14 13 $106.00
90472 Immunization administration, each additional vaccine (list separately) 1,973 1,033 $79.10
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 250 222 $70.18
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 14 13 $66.75
96110 Developmental screening, with scoring and documentation, per standardized instrument 1,223 1,165 $36.06
80053 Comprehensive metabolic panel 850 818 $21.12
99000 1,395 1,295 $6.10
36415 Collection of venous blood by venipuncture 600 556 $3.00
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 367 350 $0.00
83036 Hemoglobin; glycosylated (A1C) 1,351 1,281 $0.00
90680 457 424 $0.00
94760 345 281 $0.00
82962 298 255 $0.00
90677 262 255 $0.00
85025 Blood count; complete (CBC), automated, and automated differential WBC count 868 815 $0.00
90647 497 460 $0.00
90698 12 12 $0.00
90688 657 630 $0.00
90474 13 13 $0.00
90723 587 542 $0.00
84443 Thyroid stimulating hormone (TSH) 114 110 $0.00
91306 16 16 $0.00
H0049 Alcohol and/or drug screening 89 83 $0.00
85018 146 139 $0.00
91317 83 72 $0.00
80048 Basic metabolic panel (calcium, ionized) 30 28 $0.00
86803 119 113 $0.00
82950 14 13 $0.00
90651 46 40 $0.00
86592 86 80 $0.00
87086 Culture, bacterial; quantitative colony count, urine 18 13 $0.00
85027 34 32 $0.00
87340 133 117 $0.00
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 86 82 $0.00
90716 13 13 $0.00
91307 13 13 $0.00
90670 1,207 1,117 $0.00
80061 Lipid panel 483 458 $0.00
D0190 538 538 $0.00
91308 122 110 $0.00
81025 151 121 $0.00
90461 791 723 $0.00
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 101 96 $0.00
90648 57 55 $0.00
82948 175 157 $0.00
86480 138 128 $0.00
91312 72 65 $0.00
86708 74 70 $0.00
90473 95 91 $0.00
90685 117 113 $0.00
D1354 37 12 $0.00
90715 133 128 $0.00
D0270 14 14 $0.00
90633 171 153 $0.00
83655 49 48 $0.00
91300 28 28 $0.00
81002 41 39 $0.00
86682 19 14 $0.00
90710 16 12 $0.00
86787 57 52 $0.00
90746 47 42 $0.00
90681 43 40 $0.00