Medicaid Provider Spending

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

THEORIA MEDICAL

NPI: 1609362375 · NOVI, MI 48375 · Cardiovascular Disease Physician · NPI assigned 07/06/2018

Deactivated NPI · This NPI was deactivated on 08/09/2021. Reactivated 08/11/2021.
$9.72M
Total Medicaid Paid
462,169
Total Claims
246,300
Beneficiaries
31
Codes Billed
2019-08
First Month
2024-12
Last Month

Provider Details

Authorized OfficialVINOKUR, SVETLANA (CFO)
NPI Enumeration Date07/06/2018

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 331 $7K
2020 22,179 $506K
2021 70,613 $1.53M
2022 116,557 $2.22M
2023 117,203 $2.41M
2024 135,286 $3.05M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99309 Subsequent nursing facility care, per day, low to moderate complexity 194,081 89,164 $4.29M
99308 Subsequent nursing facility care, per day, straightforward 174,822 86,704 $3.18M
99306 Prolong nursin fac eval 15m 11,452 9,465 $565K
99310 Prolong nursin fac eval 15m 18,943 11,389 $518K
99305 8,904 7,657 $383K
99497 12,282 10,495 $225K
99307 21,559 14,019 $222K
99316 2,691 2,660 $142K
99490 Ccm add 20min 7,309 6,252 $53K
99315 1,255 1,247 $36K
99304 1,029 898 $27K
99318 739 722 $27K
99439 3,839 3,221 $22K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 335 124 $10K
G0180 Physician or allowed practitioner 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 922 920 $5K
99356 241 150 $5K
17250 245 78 $5K
99487 Ccm add 20min 296 284 $4K
99491 Ccm add 20min 263 230 $816.31
99489 Ccm add 20min 84 56 $517.24
99406 170 95 $383.28
97597 87 40 $317.48
99422 20 13 $272.22
G0317 Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99306, 99310 for nursing facility evaluation and management services). (do not report g0317 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418). (do not report g0317 for any time unit less than 15 minutes) 19 14 $218.04
99358 Prolong nursin fac eval 15m 243 146 $125.57
1101F 155 86 $0.00
96127 72 70 $0.00
80050 General health panel 15 15 $0.00
G9717 Documentation stating the patient has had a diagnosis of bipolar disorder 16 16 $0.00
1100F 65 54 $0.00
G8482 Influenza immunization administered or previously received 16 16 $0.00