Medicaid Provider Spending

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

AVANTA CLINIC LLC

NPI: 1619467826 · GLASTONBURY, CT 06033 · Internal Medicine Physician · NPI assigned 05/14/2018

$92K
Total Medicaid Paid
3,852
Total Claims
3,245
Beneficiaries
18
Codes Billed
2019-04
First Month
2024-11
Last Month

Provider Details

Authorized OfficialBANSAL, SUDEEP (OWNER)
NPI Enumeration Date05/14/2018

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 139 $5K
2020 199 $4K
2021 733 $19K
2022 862 $11K
2023 1,407 $30K
2024 512 $22K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,025 890 $69K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 232 212 $11K
99307 376 230 $4K
99305 70 58 $3K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 15 12 $948.16
91322 16 13 $729.60
90674 36 32 $710.16
90756 29 25 $533.20
93000 43 39 $472.93
90480 13 12 $120.00
1160F 431 370 $0.00
3078F 51 48 $0.00
1159F 415 356 $0.00
1036F 467 386 $0.00
3074F 184 167 $0.00
3008F 362 316 $0.00
G0008 Administration of influenza virus vaccine 13 13 $0.00
3079F 74 66 $0.00