Medicaid Provider Spending

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

LEGACY MEDICAL LLC

NPI: 1619594637 · BISMARCK, ND 58504 · Adult Medicine Physician · NPI assigned 06/26/2020

$320K
Total Medicaid Paid
10,156
Total Claims
6,296
Beneficiaries
28
Codes Billed
2020-12
First Month
2024-11
Last Month

Provider Details

Authorized OfficialWILSON, JILL (CHIEF OPERATING OFFICER)
NPI Enumeration Date06/26/2020

Related Entities

Other providers sharing the same authorized official: WILSON, JILL

ProviderCityStateTotal Paid
HARBOR PHYSICAL THERAPY SERVICES, PS ABERDEEN WA $25K
SCHNEIDER CHIROPRATIC OFFICE SC GREEN BAY WI $0.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 44 $520.84
2021 588 $3K
2022 1,521 $28K
2023 3,506 $138K
2024 4,497 $151K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99349 3,686 2,221 $176K
99348 1,218 750 $49K
99350 Prolong home eval add 15m 434 326 $44K
99336 1,039 510 $21K
99490 Ccm add 20min 522 522 $16K
99335 115 73 $5K
99309 Subsequent nursing facility care, per day, low to moderate complexity 205 165 $4K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 189 121 $3K
99439 78 78 $1K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 166 93 $1K
99345 Prolong home eval add 15m 14 13 $545.92
99337 13 13 $327.48
G9744 Patient not eligible due to active diagnosis of hypertension 298 226 $0.00
G9923 Safety concerns screen provided and negative 33 30 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 1,715 776 $0.00
G9916 Functional status performed once in the last 12 months 17 16 $0.00
G8783 Normal blood pressure reading documented, follow-up not required 13 12 $0.00
G9920 Screening performed and negative 17 15 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 46 43 $0.00
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 16 15 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 16 13 $0.00
1123F 59 48 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 20 19 $0.00
G8734 Elder maltreatment screen documented as negative, follow-up is not required 74 65 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 16 15 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 100 86 $0.00
G9717 Documentation stating the patient has had a diagnosis of bipolar disorder 16 14 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 21 18 $0.00