Physician
Providence Health Services INC
Providence Health Services INC was paid $13.41M by Medicaid between Jan 2018 and Dec 2024, across 118 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 54% of everything it billed.
33Billing provider infoPROVIDENCE HEALTH SERVICES INC
WASHINGTON, DC 20017
WASHINGTON, DC 20017
33aNPI1669453809assigned 11/06/2005
33bProvider typeInternal Medicine Physician
28Total paid$13.41M
24GClaims241,942
24DCodes billed118
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in District of Columbia
Rank by total paid#1 of 62
Median peer was paid$25K
This provider vs. median536×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 71,796 | $2.84M | |
| 2019 | 40,013 | $1.75M | |
| 2020 | 26,960 | $1.40M | |
| 2021 | 36,137 | $1.84M | |
| 2022 | 28,034 | $2.03M | |
| 2023 | 22,298 | $1.99M | |
| 2024incomplete | 16,704 | $1.57M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 54% | 101,174 | 81,223 | $7.21M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 18% | 47,386 | 39,167 | $2.41M |
| T2022 | Case management, per month | 11% | 11,455 | 9,143 | $1.44M |
| T2023 | Targeted case management; per month | 3.8% | 3,261 | 2,790 | $504K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 2.0% | 3,871 | 2,410 | $273K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 1,022 | 974 | $121K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 3,879 | 1,293 | $106K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 946 | 867 | $105K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 1,632 | 648 | $89K |
| 99442 | <1% | 1,676 | 1,609 | $77K | |
| 0012A | <1% | 2,425 | 2,321 | $76K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 1,283 | 1,046 | $73K |
106 more codes
| 0011A | <1% | 2,499 | $69K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 632 | $64K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 1,493 | $56K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 1,341 | $42K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 4,794 | $42K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 2,040 | $42K |
| 99223 | Prolong inpt eval add15 m | <1% | 544 | $40K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 317 | $34K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 292 | $32K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 2,386 | $30K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 368 | $29K |
| 92551 | <1% | 2,093 | $25K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,084 | $25K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 213 | $24K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 118 | $20K |
| 20610 | <1% | 903 | $20K | |
| 90674 | <1% | 1,396 | $19K | |
| 0064A | <1% | 892 | $19K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 544 | $17K |
| 99307 | <1% | 5,081 | $17K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 337 | $17K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 120 | $14K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 970 | $13K |
| 99243 | <1% | 126 | $13K | |
| 99173 | <1% | 3,761 | $12K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 135 | $10K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 2,096 | $10K |
| 99441 | <1% | 634 | $9K | |
| 90461 | <1% | 407 | $9K | |
| 99252 | <1% | 123 | $8K | |
| 90686 | <1% | 873 | $8K | |
| 73630 | <1% | 443 | $8K | |
| 88312 | <1% | 304 | $7K | |
| 83037 | <1% | 1,646 | $6K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 52 | $5K |
| 97804 | <1% | 199 | $5K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 109 | $5K |
| 99406 | <1% | 515 | $5K | |
| 73562 | <1% | 273 | $5K | |
| 85060 | <1% | 513 | $4K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 59 | $4K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 312 | $4K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 317 | $4K |
| 99292 | <1% | 153 | $4K | |
| 99443 | <1% | 140 | $4K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 283 | $4K |
| 73610 | <1% | 258 | $4K | |
| 88313 | <1% | 326 | $4K | |
| 93000 | <1% | 503 | $4K | |
| 99220 | <1% | 44 | $3K | |
| 0134A | <1% | 134 | $3K | |
| 97803 | <1% | 26 | $3K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 1,155 | $3K |
| 73564 | <1% | 202 | $3K | |
| 99219 | <1% | 32 | $3K | |
| 95811 | <1% | 35 | $3K | |
| 90658 | <1% | 244 | $2K | |
| 97802 | <1% | 18 | $2K | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 640 | $2K |
| 96127 | <1% | 361 | $2K | |
| 0031A | <1% | 78 | $1K | |
| 99385 | <1% | 12 | $1K | |
| 92557 | <1% | 143 | $1K | |
| 99205 | Prolong outpt/office vis | <1% | 12 | $1K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 18 | $1K |
| 94760 | <1% | 502 | $856.81 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 980 | $841.54 |
| 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) | <1% | 405 | $831.59 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 170 | $804.74 |
| 90656 | <1% | 79 | $788.96 | |
| 31575 | <1% | 17 | $778.63 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 42 | $765.11 |
| 69210 | <1% | 47 | $694.36 | |
| 73130 | <1% | 28 | $643.46 | |
| 90661 | <1% | 56 | $572.20 | |
| 92550 | <1% | 102 | $563.30 | |
| 90756 | <1% | 55 | $476.70 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 57 | $440.45 |
| 71047 | <1% | 26 | $423.24 | |
| 99397 | <1% | 16 | $314.24 | |
| 88304 | <1% | 32 | $300.43 | |
| 90715 | <1% | 37 | $219.53 | |
| 90662 | <1% | 255 | $200.37 | |
| 90734 | <1% | 14 | $164.15 | |
| 73030 | <1% | 16 | $157.17 | |
| 86803 | <1% | 16 | $154.63 | |
| 88108 | <1% | 17 | $145.93 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 19 | $141.92 |
| 81002 | <1% | 54 | $135.95 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 18 | $122.11 |
| 81025 | <1% | 14 | $89.97 | |
| G0008 | Administration of influenza virus vaccine | <1% | 977 | $70.41 |
| 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 | <1% | 290 | $69.53 |
| 90649 | <1% | 14 | $56.10 | |
| 90694 | <1% | 18 | $53.14 | |
| 82962 | <1% | 3,260 | $39.75 | |
| 99310 | Prolong nursin fac eval 15m | <1% | 13 | $30.47 |
| 81000 | <1% | 16 | $28.57 | |
| 91301 | <1% | 2,364 | $0.12 | |
| 99499 | <1% | 2,759 | $0.02 | |
| 99497 | 0% | 237 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 76 | $0.00 |
| 90655 | 0% | 12 | $0.00 | |
| 91306 | 0% | 202 | $0.00 | |
| 91303 | 0% | 33 | $0.00 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 0% | 416 | $-10.16 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLOMAX, MITCHELL (VICE PRESIDENT/CFO)
Parent organizationPROVIDENCE HOSPITAL