Medicaid Provider Spending

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

NPI: 1619504735 · SALISBURY, MD 21801 · Medical Specialty Clinic/Center · NPI assigned 03/26/2020

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

Authorized official PELOT, WILLIAM controls 15+ related entities in our dataset. Read more

$11.72M
Total Medicaid Paid
322,548
Total Claims
221,467
Beneficiaries
98
Codes Billed
2020-09
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPELOT, WILLIAM (CHIEF ADMINISTRATIVE OFFICER)
NPI Enumeration Date03/26/2020

Related Entities

Other providers sharing the same authorized official: PELOT, WILLIAM

ProviderCityStateTotal Paid
TIDALHEALTH PHYSICIAN NETWORK, INC. SEAFORD DE $8.80M
TIDALHEALTH PHYSICIAN NETWORK, INC. SEAFORD DE $2.86M
TIDALHEALTH PRIMARY CARE, LLC SALISBURY MD $2.44M
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $841K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $39K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $32K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $9K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $5K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $3K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $3K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $2K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $1K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $562.99
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $535.19
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $308.26

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 12,374 $475K
2021 64,290 $2.22M
2022 89,574 $3.24M
2023 95,557 $3.62M
2024 60,753 $2.17M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 51,894 38,450 $3.68M
99223 Prolong inpt eval add15 m 11,846 8,623 $1.13M
99233 Prolong inpt eval add15 m 18,760 8,644 $804K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 16,438 12,926 $790K
99232 Subsequent hospital care, per day, moderate complexity 27,868 8,046 $764K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 9,561 7,876 $707K
99220 5,123 3,925 $543K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 4,142 3,382 $330K
99239 Hospital discharge day management, more than 30 minutes 6,371 5,369 $277K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 937 486 $273K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 743 600 $254K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 41,685 28,972 $209K
93000 12,597 10,034 $205K
99222 Initial hospital care, per day, moderate complexity 3,497 2,753 $153K
99215 Prolong outpt/office vis 2,713 2,274 $150K
G8420 Bmi is documented within normal parameters and no follow-up plan is required 4,780 3,926 $112K
95810 Polysomnography; sleep staging with 4 or more additional parameters 874 600 $105K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,086 916 $98K
3074F 17,382 12,586 $86K
J2785 Injection, regadenoson, 0.1 mg 660 578 $77K
99231 Subsequent hospital care, per day, straightforward or low complexity 4,314 1,556 $76K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,002 816 $66K
3078F 13,335 9,695 $63K
99226 1,469 1,130 $50K
3044F 3,944 3,191 $49K
93015 1,127 975 $43K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 659 560 $42K
3079F 6,947 4,996 $33K
95811 261 176 $31K
99238 Hospital discharge day management, 30 minutes or less 552 502 $30K
93298 2,061 1,816 $30K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 750 341 $29K
99217 968 843 $28K
99460 287 271 $27K
99205 Prolong outpt/office vis 366 320 $23K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 4,753 3,389 $23K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,130 918 $22K
62323 247 159 $19K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 1,594 1,377 $19K
94726 1,902 1,409 $16K
3051F 1,115 851 $15K
94375 1,471 1,097 $15K
3075F 3,072 2,288 $13K
94729 1,942 1,448 $11K
83036 Hemoglobin; glycosylated (A1C) 1,347 824 $11K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 81 63 $11K
99225 515 397 $11K
3052F 678 520 $10K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 134 65 $10K
3046F 781 528 $10K
85610 4,096 2,355 $9K
1100F 328 302 $9K
93296 733 681 $9K
95251 435 325 $8K
93280 358 305 $7K
93793 3,099 1,957 $7K
99442 207 204 $7K
99219 123 118 $5K
99221 175 143 $5K
3077F 1,779 1,280 $5K
99462 113 94 $5K
93248 331 301 $5K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 29 27 $5K
93244 350 326 $5K
54150 60 50 $4K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,106 691 $4K
94060 353 251 $4K
99406 92 79 $3K
93458 36 24 $3K
93018 346 284 $3K
96127 555 359 $3K
93016 329 269 $2K
95816 57 54 $2K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 28 16 $2K
97803 48 41 $2K
93970 118 100 $2K
93308 198 159 $2K
93290 31 26 $2K
90686 86 49 $1K
93227 115 95 $1K
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 54 52 $1K
93971 106 84 $1K
27096 29 27 $703.54
93242 123 113 $696.63
Q3014 Telehealth originating site facility fee 53 28 $685.11
93295 101 98 $680.73
93246 121 103 $637.84
99441 30 27 $599.64
93297 39 34 $455.70
1124F 40 39 $420.14
99152 49 28 $306.68
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 51 26 $259.57
93294 38 37 $225.22
93325 20 17 $86.80
3080F 538 429 $0.00
1101F 3,020 2,401 $0.00
3288F 4,635 3,447 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 26 25 $0.00