Medicaid Provider Spending

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

SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC.

NPI: 1588603567 · POTTSVILLE, PA 17901 · Endocrinology, Diabetes & Metabolism Physician · NPI assigned 06/06/2006

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

Authorized official DEMOPOULOS, JAMES controls 14+ related entities in our dataset. Read more

$2.41M
Total Medicaid Paid
78,886
Total Claims
70,394
Beneficiaries
58
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialDEMOPOULOS, JAMES (SR VP & COO)
NPI Enumeration Date06/06/2006

Related Entities

Other providers sharing the same authorized official: DEMOPOULOS, JAMES

ProviderCityStateTotal Paid
FAMILY CARE CENTERS INC. E STROUDSBURG PA $11.08M
HAZLETON PROFESSIONAL SERVICES HAZLETON PA $8.26M
FAMILY CARE CENTERS INC EAST STROUDSBURG PA $6.09M
SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC. POTTSVILLE PA $1.15M
LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA $225K
LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA $190K
LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA $157K
LEHIGH VALLEY PHYSICIAN GROUP WHITEHALL PA $107K
LEHIGH VALLEY PHYSICIAN GROUP DICKSON CITY PA $17K
LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA $15K
LEHIGH VALLEY PHYSICIAN GROUP BETHLEHEM PA $7K
LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA $6K
LEHIGH VALLEY PHYSICIAN GROUP SCRANTON PA $4K
LEHIGH VALLEY PHYSICIAN GROUP BETHLEHEM PA $479.15

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,888 $14K
2019 4,370 $103K
2020 5,668 $172K
2021 16,614 $516K
2022 16,217 $477K
2023 18,683 $601K
2024 15,446 $524K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 25,525 22,712 $1.07M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 8,826 8,418 $435K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 19,105 15,995 $122K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 1,647 1,549 $118K
99309 Subsequent nursing facility care, per day, low to moderate complexity 5,672 5,074 $93K
76830 Ultrasound, transvaginal 996 959 $81K
99460 959 934 $71K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 2,446 2,427 $55K
59025 Fetal non-stress test 3,060 2,224 $52K
99238 Hospital discharge day management, 30 minutes or less 1,148 1,118 $43K
20610 817 616 $33K
T1001 Nursing assessment / evaluation 168 168 $32K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 366 360 $30K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 705 699 $21K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 299 296 $17K
76813 150 149 $16K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 241 240 $12K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 135 131 $12K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 353 336 $10K
93000 597 588 $9K
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 12 12 $9K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 26 26 $8K
90686 714 712 $6K
99462 282 211 $6K
99308 Subsequent nursing facility care, per day, straightforward 451 408 $6K
90715 750 733 $5K
99464 102 99 $5K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 199 198 $4K
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 216 211 $4K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 52 38 $3K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 247 234 $3K
81025 584 574 $3K
99222 Initial hospital care, per day, moderate complexity 16 14 $2K
99442 98 95 $2K
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 549 540 $1K
93296 103 102 $1K
54150 12 12 $1K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 53 53 $1K
99310 Prolong nursin fac eval 15m 29 28 $914.46
99441 103 102 $874.66
99215 Prolong outpt/office vis 13 12 $826.58
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 51 49 $722.92
90656 147 147 $430.50
99385 14 14 $324.60
G0008 Administration of influenza virus vaccine 46 46 $230.00
J1030 Injection, methylprednisolone acetate, 40 mg 400 382 $183.21
93018 13 12 $175.39
3074F 40 40 $125.00
96127 25 25 $108.15
3078F 15 15 $75.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 24 24 $0.00
90746 12 12 $0.00
91320 13 13 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 168 116 $0.00
J1010 Injection, methylprednisolone acetate, 1 mg 42 42 $0.00
99318 12 12 $0.00
90739 24 24 $0.00
90677 14 14 $0.00