Medicaid Provider Spending

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

POTTSTOWN CLINIC COMPANY LLC

NPI: 1649341934 · POTTSTOWN, PA 19465 · Pediatrics Physician · NPI assigned 11/10/2006

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

Authorized official RAYME, BRIAN controls 20+ related entities in our dataset. Read more

$2.96M
Total Medicaid Paid
56,039
Total Claims
51,626
Beneficiaries
43
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialRAYME, BRIAN (EVP & CFO)
NPI Enumeration Date11/10/2006

Related Entities

Other providers sharing the same authorized official: RAYME, BRIAN

ProviderCityStateTotal Paid
STC OPCO LLC PHILADELPHIA PA $69.20M
TOWER HEALTH URGENT CARE, LLC DOUGLASSVILLE PA $11.77M
POTTSTOWN HOSPITAL, LLC POTTSTOWN PA $7.54M
PHOENIXVILLE HOSPITAL, LLC PHOENIXVILLE PA $4.61M
TOWER DREXEL ACADEMIC MEDICAL GROUP LLC PHILADELPHIA PA $2.47M
STC OPCO LLC PHILADELPHIA PA $2.06M
STC PEDIATRICS LLC PHILADELPHIA PA $2.06M
STC PEDIATRICS LLC PHILADELPHIA PA $1.73M
PHOENIXVILLE CLINIC COMPANY LLC PHOENIXVILLE PA $1.68M
STC PEDIATRICS LLC PHILADELPHIA PA $1.48M
STC PEDIATRICS LLC PHILADELPHIA PA $1.31M
TOWER HEALTH MEDICAL GROUP WYOMISSING PA $1.28M
STC PEDIATRICS LLC PHILADELPHIA PA $988K
TOWER HEALTH MEDICAL GROUP WEST READING PA $850K
TOWER HEALTH MEDICAL GROUP WEST READING PA $724K
TOWER HEALTH MEDICAL GROUP WEST READING PA $720K
TOWER HEALTH MEDICAL GROUP BIRDSBORO PA $543K
STC PEDIATRICS LLC PHILADELPHIA PA $497K
STC PEDIATRICS LLC PHILADELPHIA PA $462K
STC PEDIATRICS LLC PHILADELPHIA PA $449K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 461 $11K
2019 623 $17K
2020 6,571 $292K
2021 18,229 $772K
2022 13,609 $628K
2023 10,682 $706K
2024 5,864 $536K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 20,542 19,994 $1.32M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 4,850 4,740 $356K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 5,321 5,180 $278K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5,859 5,560 $214K
99283 Emergency department visit for the evaluation and management, moderate severity 3,139 3,062 $154K
99223 Prolong inpt eval add15 m 1,428 1,376 $137K
99232 Subsequent hospital care, per day, moderate complexity 3,257 999 $98K
99282 Emergency department visit for the evaluation and management, low to moderate severity 2,976 2,902 $85K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,440 1,361 $66K
99233 Prolong inpt eval add15 m 873 373 $52K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 614 611 $50K
99205 Prolong outpt/office vis 192 187 $22K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 307 304 $19K
90460 Immunization administration through 18 years of age via any route, first or only component 1,061 852 $17K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 202 199 $16K
99220 199 197 $15K
99239 Hospital discharge day management, more than 30 minutes 227 218 $14K
88342 326 312 $11K
90686 953 948 $6K
99222 Initial hospital care, per day, moderate complexity 42 40 $5K
90670 390 389 $4K
99238 Hospital discharge day management, 30 minutes or less 30 30 $3K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 29 29 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 53 53 $3K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 329 321 $2K
90715 150 150 $2K
90698 392 391 $2K
88304 201 194 $2K
90651 42 42 $2K
99221 21 21 $1K
88307 31 31 $1K
90680 158 157 $946.65
90633 149 149 $928.55
90744 98 98 $750.47
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 30 29 $538.80
88312 12 12 $413.66
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 25 24 $294.80
90734 20 20 $121.85
96160 16 16 $52.39
90707 19 19 $0.00
90710 12 12 $0.00
90619 12 12 $0.00
90696 12 12 $0.00