Medicaid Provider Spending

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

EVERGREEN PEDIATRICS, LLC

NPI: 1689839144 · EVERGREEN, CO 80439 · Pediatrics Physician · NPI assigned 07/24/2008

$585K
Total Medicaid Paid
19,057
Total Claims
17,221
Beneficiaries
32
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKUTALEK, KENNETH (OWNER)
NPI Enumeration Date07/24/2008

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,922 $149K
2019 4,184 $131K
2020 1,883 $54K
2021 1,965 $66K
2022 1,734 $61K
2023 2,434 $74K
2024 1,935 $51K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3,736 3,263 $230K
90460 Immunization administration through 18 years of age via any route, first or only component 2,695 2,496 $100K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 630 561 $56K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 453 423 $40K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 342 331 $31K
96110 Developmental screening, with scoring and documentation, per standardized instrument 1,552 1,484 $27K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 316 287 $27K
92551 1,461 1,344 $15K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 148 140 $14K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 859 771 $12K
99173 1,433 1,318 $11K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 811 732 $8K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 561 301 $6K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 59 57 $3K
99000 1,239 1,097 $2K
81002 571 542 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 80 71 $1K
90686 1,071 1,016 $797.39
90461 191 171 $507.00
G0136 Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months 176 162 $209.30
90656 57 55 $133.97
90734 55 54 $87.50
36416 30 26 $82.16
94760 16 13 $34.44
90648 131 129 $0.00
90670 154 152 $0.00
90633 28 27 $0.00
90710 18 17 $0.00
90651 84 83 $0.00
90723 67 67 $0.00
87807 18 17 $0.00
90696 15 14 $0.00