Medicaid Provider Spending

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

SUMNER PHYSICIAN PRACTICES LLC

NPI: 1730637190 · GALLATIN, TN 37066 · Internal Medicine Physician · NPI assigned 09/14/2016

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

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

$672K
Total Medicaid Paid
35,626
Total Claims
28,266
Beneficiaries
43
Codes Billed
2018-03
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLAWRENCE, CHARLOTTE (SECRETARY)
NPI Enumeration Date09/14/2016

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 76 $4K
2019 361 $6K
2020 2,150 $51K
2021 6,278 $181K
2022 7,121 $123K
2023 6,354 $153K
2024 13,286 $155K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 6,129 5,313 $282K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,194 6,859 $226K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,280 1,021 $90K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 977 833 $43K
20610 435 261 $11K
73110 248 181 $3K
73562 230 183 $3K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 169 148 $2K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 75 43 $2K
11720 251 160 $1K
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) 320 213 $805.61
73100 62 41 $758.07
97597 94 36 $749.38
99215 Prolong outpt/office vis 14 12 $718.00
83036 Hemoglobin; glycosylated (A1C) 343 240 $705.87
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 18 12 $642.10
73610 55 40 $629.13
J1030 Injection, methylprednisolone acetate, 40 mg 196 138 $555.42
95251 72 55 $496.46
87428 18 14 $480.77
99222 Initial hospital care, per day, moderate complexity 15 12 $412.01
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 50 24 $380.23
11056 66 43 $287.74
11719 188 120 $230.55
99442 19 13 $215.67
3074F 1,729 1,536 $181.20
3078F 1,680 1,486 $170.00
73560 18 13 $136.81
11721 18 12 $114.06
72100 16 12 $111.80
3079F 194 148 $101.19
73020 15 12 $98.57
J1100 Injection, dexamethasone sodium phosphate, 1 mg 84 65 $50.40
J1010 Injection, methylprednisolone acetate, 1 mg 23 15 $45.75
3075F 34 25 $30.00
1036F 2,025 1,655 $0.02
99024 3,633 2,515 $0.00
3008F 2,912 2,448 $0.00
1126F 49 40 $0.00
1034F 94 76 $0.00
1035F 13 12 $0.00
1160F 1,285 1,090 $0.00
1159F 1,286 1,091 $0.00