Medicaid Provider Spending

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

PROSPECT CHARTERCARE SJHSRI, LLC

NPI: 1588089759 · NORTH PROVIDENCE, RI 02904 · Social Worker · NPI assigned 02/25/2014

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

Authorized official ELDERS, ROBERT controls 20+ related entities in our dataset. Read more

$858K
Total Medicaid Paid
40,990
Total Claims
26,442
Beneficiaries
45
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialELDERS, ROBERT (SECRETARY)
NPI Enumeration Date02/25/2014

Related Entities

Other providers sharing the same authorized official: ELDERS, ROBERT

ProviderCityStateTotal Paid
PROSPECT WATERBURY, INC. WATERBURY CT $84.62M
PROSPECT MANCHESTER HOSPITAL, INC. MANCHESTER CT $69.20M
PROSPECT CHARTERCARE RWMC, LLC PROVIDENCE RI $57.10M
PROSPECT CCMC, LLC CHESTER PA $40.89M
PROSPECT CT MEDICAL FOUNDATION, INC. MANCHESTER CT $34.07M
PROSPECT ROCKVILLE HOSPITAL, INC. VERNON CT $30.06M
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $10.94M
PROSPECT DCMH, LLC DREXEL HILL PA $10.37M
PROSPECT CCMC, LLC CHESTER PA $5.46M
ALTA LOS ANGELES HOSPITALS, INC. LOS ANGELES CA $5.42M
PROSPECT CCMC, LLC CHESTER PA $5.03M
PROSPECT CCMC, LLC CHESTER PA $3.71M
PROSPECT CHARTERCARE PHYSICIANS, LLC CRANSTON RI $2.31M
PROSPECT ECHN HOME HEALTH, INC. VERNON CT $1.75M
PROSPECT WATERBURY HOME HEALTH, INC. WATERTOWN CT $1.30M
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $1.22M
ALTA NEWPORT HOSPITAL, LLC TUSTIN CA $1.16M
PROSPECT HEALTH ACCESS NETWORK, INC. CRUM LYNNE PA $924K
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $872K
PROSPECT HEALTH ACCESS NETWORK, INC. DREXEL HILL PA $815K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,030 $30K
2019 5,426 $94K
2020 3,730 $24K
2021 5,375 $61K
2022 7,860 $195K
2023 8,284 $255K
2024 6,285 $199K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 8,280 7,452 $278K
99231 Subsequent hospital care, per day, straightforward or low complexity 9,559 1,725 $119K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 674 671 $66K
90834 Psychotherapy, 45 minutes with patient 950 740 $62K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 591 585 $49K
99232 Subsequent hospital care, per day, moderate complexity 2,545 592 $49K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 384 380 $33K
90791 Psychiatric diagnostic evaluation 738 645 $31K
90832 Psychotherapy, 30 minutes with patient 616 566 $26K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 326 266 $16K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,460 1,315 $16K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 428 407 $15K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 153 151 $13K
99239 Hospital discharge day management, more than 30 minutes 148 142 $11K
90472 Immunization administration, each additional vaccine (list separately) 954 493 $11K
99223 Prolong inpt eval add15 m 74 72 $9K
83037 575 574 $7K
99233 Prolong inpt eval add15 m 600 167 $6K
99238 Hospital discharge day management, 30 minutes or less 109 106 $5K
1160F 1,566 1,356 $3K
3008F 1,443 1,286 $3K
1036F 1,560 1,344 $3K
3078F 1,242 1,102 $3K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 159 149 $3K
93000 163 155 $3K
1159F 1,331 1,136 $3K
4004F 1,336 1,156 $3K
99222 Initial hospital care, per day, moderate complexity 101 89 $2K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 25 25 $2K
3077F 700 608 $1K
H2016 Comprehensive community support services, per diem 1,173 27 $1K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 108 102 $584.21
90785 273 251 $355.26
3074F 143 125 $326.54
3075F 68 64 $280.08
4010F 48 48 $269.56
1126F 63 59 $263.00
1220F 71 61 $229.41
82044 39 39 $223.67
3725F 55 55 $171.63
G9664 Patients who are currently statin therapy users or received an order (prescription) for statin therapy 43 43 $131.75
82962 33 30 $41.05
G8510 Screening for depression is documented as negative, a follow-up plan is not required 26 26 $22.69
96127 12 12 $4.26
90686 45 45 $0.44