Medicaid Provider Spending

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

PROSPECT CHARTERCARE PHYSICIANS, LLC

NPI: 1629493135 · CRANSTON, RI 02920 · Nutritionist · NPI assigned 02/20/2014

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

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

$2.31M
Total Medicaid Paid
87,161
Total Claims
77,184
Beneficiaries
94
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialELDERS, ROBERT (SECRETARY)
NPI Enumeration Date02/20/2014

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 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. CRUM LYNNE PA $924K
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 12,245 $350K
2019 10,627 $353K
2020 8,842 $158K
2021 14,971 $190K
2022 21,903 $388K
2023 10,568 $568K
2024 8,005 $305K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 18,371 16,239 $721K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 21,724 18,718 $620K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,443 1,387 $255K
62323 1,108 1,086 $146K
99404 1,009 970 $106K
97803 1,559 1,504 $74K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,147 1,053 $44K
45380 Colonoscopy, flexible; with biopsy, single or multiple 134 128 $29K
99205 Prolong outpt/office vis 197 186 $29K
99215 Prolong outpt/office vis 508 487 $28K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 697 591 $26K
93000 2,220 1,992 $24K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,534 1,324 $24K
62321 166 162 $23K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 79 77 $20K
99152 236 227 $12K
99308 Subsequent nursing facility care, per day, straightforward 1,240 579 $9K
1036F 3,447 3,041 $9K
3008F 3,543 3,201 $8K
1160F 4,160 3,692 $8K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 106 104 $7K
1159F 3,190 2,826 $6K
99223 Prolong inpt eval add15 m 173 155 $6K
95251 232 222 $6K
97802 72 72 $5K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 487 426 $4K
3078F 1,925 1,773 $4K
3074F 1,738 1,592 $3K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 54 53 $3K
99443 95 91 $3K
83036 Hemoglobin; glycosylated (A1C) 565 539 $3K
43235 14 12 $2K
G9664 Patients who are currently statin therapy users or received an order (prescription) for statin therapy 855 793 $2K
94729 218 199 $2K
43644 13 12 $2K
1126F 833 776 $2K
99232 Subsequent hospital care, per day, moderate complexity 158 49 $2K
94726 191 171 $2K
G8754 Most recent diastolic blood pressure < 90 mmhg 630 574 $2K
4010F 631 582 $2K
99309 Subsequent nursing facility care, per day, low to moderate complexity 244 131 $2K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 33 28 $2K
90792 Psychiatric diagnostic evaluation with medical services 14 14 $2K
G8752 Most recent systolic blood pressure < 140 mmhg 575 527 $1K
90480 44 40 $1K
1220F 596 548 $1K
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) 139 123 $1K
82962 554 520 $1K
3725F 585 552 $1K
3017F 516 479 $1K
3075F 486 467 $1K
3079F 571 529 $966.69
83013 17 13 $891.99
G8510 Screening for depression is documented as negative, a follow-up plan is not required 174 165 $778.31
99401 49 48 $750.32
3288F 692 631 $721.39
1100F 144 129 $645.45
96127 198 189 $529.76
3014F 265 242 $516.08
87400 61 57 $493.04
99310 Prolong nursin fac eval 15m 138 79 $468.60
3077F 259 230 $458.99
4145F 194 180 $451.80
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 47 43 $415.46
11100 17 16 $415.24
1170F 435 401 $407.38
1101F 85 81 $329.53
95816 12 12 $324.91
1125F 404 378 $305.00
3044F 111 104 $301.30
99442 49 25 $287.84
3080F 16 16 $257.52
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 29 29 $257.22
94060 33 24 $247.23
94010 43 43 $222.61
99406 27 26 $181.55
83014 17 13 $104.03
G0008 Administration of influenza virus vaccine 453 436 $94.37
83037 12 12 $86.24
82270 29 28 $70.66
99000 29 25 $61.80
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 1,048 950 $53.78
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 24 24 $47.64
4004F 14 13 $47.64
99497 268 245 $41.74
3061F 72 67 $39.71
1158F 340 311 $38.12
81002 16 12 $32.62
G8482 Influenza immunization administered or previously received 178 170 $20.24
90686 15 14 $19.60
1111F 18 16 $0.00
G0009 Administration of pneumococcal vaccine 17 16 $0.00
0003A 36 33 $0.00
0013A 17 15 $0.00