Medicaid Provider Spending

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

FAIRWAY CHILDREN'S MEDICAL GROUP

NPI: 1700510898 · WEST COVINA, CA 91792 · Pediatrics Physician · NPI assigned 07/13/2022

$54K
Total Medicaid Paid
32,818
Total Claims
31,256
Beneficiaries
50
Codes Billed
2024-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialCHAN, JACKYLN (OWNER)
NPI Enumeration Date07/13/2022

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 32,818 $54K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G9920 Screening performed and negative 2,748 2,737 $8K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,729 2,469 $7K
96156 2,384 2,376 $6K
92552 1,685 1,678 $5K
96110 Developmental screening, with scoring and documentation, per standardized instrument 940 854 $4K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 957 956 $3K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 941 892 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 564 564 $3K
92551 502 502 $2K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 526 525 $2K
69210 90 89 $1K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 694 688 $1K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 83 83 $946.90
90686 210 210 $878.00
90651 361 359 $804.00
99383 27 27 $790.98
90460 Immunization administration through 18 years of age via any route, first or only component 1,642 1,613 $737.70
90698 77 77 $704.00
90671 149 149 $598.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 399 396 $516.60
90619 200 200 $465.00
99188 837 833 $288.00
90620 137 136 $253.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 79 79 $205.80
90680 26 26 $193.00
90633 80 79 $172.00
90715 77 77 $168.00
90656 337 337 $145.41
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 253 253 $124.68
90744 25 25 $121.00
90710 43 43 $120.00
90700 38 38 $119.00
96127 729 726 $101.01
90461 522 521 $80.00
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 1,967 1,966 $68.85
G0270 Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes 2,320 2,318 $64.00
96160 2,997 2,204 $50.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 78 78 $37.25
83655 261 255 $21.26
90713 12 12 $10.00
99177 1,162 1,161 $0.00
99173 329 329 $0.00
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) 1,315 1,194 $0.00
99051 399 393 $0.00
H0049 Alcohol and/or drug screening 235 198 $0.00
99174 93 93 $0.00
94760 402 328 $0.00
36416 103 56 $0.00
85018 42 42 $0.00
90660 12 12 $0.00