Medicaid Provider Spending

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

SUMNER PHYSICIAN PRACTICES, LLC

NPI: 1750765434 · GALLATIN, TN 37066 · Internal Medicine Physician · NPI assigned 07/13/2015

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

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

$521K
Total Medicaid Paid
53,427
Total Claims
35,589
Beneficiaries
30
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLAWRENCE, CHARLOTTE (SECRETARY)
NPI Enumeration Date07/13/2015

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 426 $4K
2019 1,121 $19K
2020 2,434 $75K
2021 3,860 $104K
2022 15,070 $107K
2023 9,076 $112K
2024 21,440 $100K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 16,082 11,255 $389K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,454 1,055 $74K
64493 305 127 $13K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,178 902 $13K
64635 48 24 $6K
64494 275 115 $5K
99443 253 190 $5K
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) 1,131 766 $4K
64636 50 24 $3K
J1030 Injection, methylprednisolone acetate, 40 mg 741 456 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 32 31 $2K
27096 16 12 $2K
99442 85 65 $713.77
99222 Initial hospital care, per day, moderate complexity 13 13 $579.13
J1010 Injection, methylprednisolone acetate, 1 mg 132 78 $323.37
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 23 12 $295.06
J1100 Injection, dexamethasone sodium phosphate, 1 mg 490 241 $207.90
99441 18 13 $95.08
3078F 2,457 1,603 $50.02
3079F 1,367 921 $50.00
3077F 2,315 1,554 $40.02
3075F 1,063 699 $20.00
3080F 1,162 815 $20.00
3074F 1,572 1,050 $20.00
1036F 3,139 2,039 $0.02
1125F 6,076 3,974 $0.02
1159F 2,806 1,765 $0.02
1160F 2,807 1,766 $0.02
1034F 2,728 1,733 $0.00
3008F 3,609 2,291 $0.00