Medicaid Provider Spending

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

SUMNER PHYSICIAN PRACTICES LLC

NPI: 1730541145 · GALLATIN, TN 37066 · Family Medicine Physician · NPI assigned 03/24/2016

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

Authorized official LAWRENCE, CHARLOTTE controls 20+ related entities in our dataset. Read more

$457K
Total Medicaid Paid
40,228
Total Claims
29,785
Beneficiaries
30
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLAWRENCE, CHARLOTTE (SECRETARY)
NPI Enumeration Date03/24/2016

Related Entities

Other providers sharing the same authorized official: LAWRENCE, CHARLOTTE

ProviderCityStateTotal Paid
LAKE CUMBERLAND REGIONAL HOSPITAL LLC SOMERSET KY $77.77M
DANVILLE REGIONAL MEDICAL CENTER, LLC DANVILLE VA $65.11M
PHC-LAS CRUCES INC LAS CRUCES NM $64.77M
GEORGETOWN COMMUNITY HOSPITAL LLC GEORGETOWN KY $44.03M
PINELAKE REGIONAL HOSPITAL LLC MAYFIELD KY $43.34M
RALEIGH GENERAL HOSPITAL LLC BECKLEY WV $36.44M
LOURDES HOSPITAL LLC PASCO WA $33.94M
RCHP-SIERRA VISTA INC SIERRA VISTA AZ $29.77M
CLINCH VALLEY MEDICAL CENTER INC. RICHLANDS VA $26.28M
SPRING VIEW HOSPITAL LLC LEBANON KY $23.35M
HAVASU REGIONAL MEDICAL CENTER LLC LAKE HAVASU CITY AZ $23.19M
LAS CRUCES PHYSICIAN PRACTICES, LLC LAS CRUCES NM $22.78M
MEADOWVIEW REGIONAL MEDICAL CENTER LLC MAYSVILLE KY $22.57M
LOURDES HOSPITAL LLC RICHLAND WA $22.38M
DANVILLE REGIONAL MEDICAL CENTER LLC MARTINSVILLE VA $21.09M
PHC-FORT MOHAVE INC FORT MOHAVE AZ $19.95M
WYTHE COUNTY COMMUNITY HOSPITAL LLC WYTHEVILLE VA $18.30M
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC JOHNSTOWN PA $18.22M
BOURBON COMMUNITY HOSPITAL LLC PARIS KY $18.14M
WILLAMETTE VALLEY MEDICAL CENTER LLC MCMINNVILLE OR $17.29M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,524 $45K
2019 1,320 $40K
2020 1,383 $46K
2021 2,396 $69K
2022 9,512 $73K
2023 13,430 $113K
2024 10,663 $71K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 5,553 4,110 $219K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6,283 4,551 $203K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 265 205 $17K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 879 586 $10K
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) 470 315 $2K
90674 101 76 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 139 109 $1K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 39 24 $686.69
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 50 25 $621.03
90686 48 43 $572.96
3079F 1,975 1,515 $550.00
3074F 3,000 2,268 $470.02
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 48 40 $398.27
3078F 1,872 1,369 $231.87
99442 31 14 $229.80
90656 19 13 $214.38
3077F 590 442 $200.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 124 70 $136.19
3080F 444 365 $130.00
J1030 Injection, methylprednisolone acetate, 40 mg 18 16 $73.65
3075F 471 364 $62.53
81002 21 14 $36.94
1036F 3,428 2,539 $0.04
1159F 3,949 2,947 $0.02
1160F 3,951 2,949 $0.02
1034F 1,109 792 $0.00
3008F 3,982 2,959 $0.00
1125F 771 563 $0.00
1126F 486 401 $0.00
3725F 112 101 $0.00