Medicaid Provider Spending

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

ST. ISABEL FAMILY MEDICAL CLINIC, INC.

NPI: 1700057981 · HARBOR CITY, CA 90710 · Primary Care Clinic/Center · NPI assigned 03/17/2008

$44K
Total Medicaid Paid
11,418
Total Claims
11,150
Beneficiaries
25
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialDE BODA, EDILITA (PRESIDENT)
NPI Enumeration Date03/17/2008

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 973 $10K
2019 1,825 $12K
2020 1,562 $5K
2021 1,303 $5K
2022 1,766 $3K
2023 2,273 $6K
2024 1,716 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,089 2,023 $19K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 3,391 3,223 $7K
92081 1,358 1,358 $3K
88150 490 489 $2K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 199 199 $2K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 411 411 $2K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 292 292 $2K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 571 561 $2K
92551 1,092 1,091 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 158 152 $785.87
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 28 28 $660.28
99215 Prolong outpt/office vis 243 235 $571.82
92552 112 112 $453.77
99385 28 28 $410.40
99386 14 14 $205.20
99000 65 63 $121.58
90734 24 24 $36.00
99384 12 12 $36.00
90460 Immunization administration through 18 years of age via any route, first or only component 30 30 $0.00
S3005 Performance measurement, evaluation of patient self assessment, depression 144 144 $0.00
90658 21 21 $0.00
99442 40 38 $0.00
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 415 413 $0.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 178 176 $0.00
90686 13 13 $0.00