Medicaid Provider Spending

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

PROSPECT HEALTH ACCESS NETWORK, INC.

NPI: 1619322112 · CRUM LYNNE, PA 19022 · Clinical Psychologist · NPI assigned 05/03/2016

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

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

$924K
Total Medicaid Paid
57,523
Total Claims
55,188
Beneficiaries
37
Codes Billed
2018-02
First Month
2024-12
Last Month

Provider Details

Authorized OfficialELDERS, ROBERT (SECRETARY)
NPI Enumeration Date05/03/2016

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. CHESTER PA $872K
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $858K
PROSPECT HEALTH ACCESS NETWORK, INC. DREXEL HILL PA $815K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 135 $3K
2019 196 $5K
2020 4,459 $68K
2021 18,981 $284K
2022 16,090 $272K
2023 10,215 $164K
2024 7,447 $127K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 27,343 26,316 $532K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 18,503 17,689 $294K
90686 2,730 2,725 $27K
99308 Subsequent nursing facility care, per day, straightforward 1,038 919 $22K
90715 605 604 $13K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 400 397 $5K
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 3,343 3,167 $4K
90732 58 58 $3K
99309 Subsequent nursing facility care, per day, low to moderate complexity 89 82 $2K
90746 46 45 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 292 264 $2K
90651 215 214 $2K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 201 201 $2K
90620 69 69 $2K
90734 250 248 $2K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 28 27 $1K
99499 45 42 $1K
90656 154 153 $946.95
90662 81 81 $934.26
86580 997 881 $901.94
99385 37 37 $773.05
99215 Prolong outpt/office vis 25 25 $574.92
0011A 13 12 $520.00
99462 27 27 $513.32
36415 Collection of venous blood by venipuncture 396 387 $512.70
99238 Hospital discharge day management, 30 minutes or less 15 14 $504.58
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 14 14 $362.29
3078F 164 155 $310.77
3074F 155 150 $210.70
90670 13 13 $132.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 44 44 $113.10
90633 14 14 $106.07
80305 29 25 $70.85
3077F 42 41 $60.31
99349 14 14 $13.54
4037F 12 12 $0.00
90653 22 22 $0.00