Medicaid Provider Spending

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

PROVIDENCE MEDICAL INSTITUTE

NPI: 1760425862 · TORRANCE, CA 90503 · Pediatrics Physician · NPI assigned 06/14/2006

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

Authorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more

$3.57M
Total Medicaid Paid
202,060
Total Claims
169,481
Beneficiaries
130
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialANDERSON, DONALD (ASSISTANT SECRETARY OF ENROLLMENTS)
NPI Enumeration Date06/14/2006

Related Entities

Other providers sharing the same authorized official: ANDERSON, DONALD

ProviderCityStateTotal Paid
PROVIDENCE HEALTH & SERVICES WASHINGTON ANCHORAGE AK $161.45M
KADLEC REGIONAL MEDICAL CENTER RICHLAND WA $151.60M
SWEDISH EDMONDS EDMONDS WA $30.06M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC EUREKA CA $28.68M
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA TORRANCE CA $27.29M
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA SAN PEDRO CA $24.26M
PROVIDENCE HEALTH & SERVICES - WASHINGTON TUKWILA WA $21.98M
SWEDISH HEALTH SERVICES SEATTLE WA $21.06M
PROVIDENCE HEALTH & SERVICES WASHINGTON KODIAK AK $11.39M
SWEDISH HEALTH SERVICES SEATTLE WA $11.08M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC FORTUNA CA $8.55M
COLLABRIA CARE NAPA CA $8.20M
PROVIDENCE HEALTH & SERVICES OREGON SEASIDE OR $8.01M
PROVIDENCE HEALTH & SERVICES- WASHINGTON SPOKANE WA $8.01M
HOSPICE OF LUBBOCK INC LUBBOCK TX $6.48M
PROVIDENCE SAINT JOHN'S HEALTH CENTER SANTA MONICA CA $5.52M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.55M
COLLABRIA CARE NAPA CA $4.05M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.01M
METHODIST HOSPITAL PLAINVIEW TEXAS PLAINVIEW TX $4.00M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 35,029 $308K
2019 43,124 $597K
2020 35,510 $548K
2021 17,254 $525K
2022 15,023 $421K
2023 22,878 $592K
2024 33,242 $576K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 42,957 39,649 $625K
99232 Subsequent hospital care, per day, moderate complexity 19,747 5,774 $461K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 13,475 13,421 $456K
99223 Prolong inpt eval add15 m 6,517 6,232 $339K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 3,501 3,492 $207K
99233 Prolong inpt eval add15 m 8,347 3,771 $194K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 17,589 16,795 $188K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2,811 2,809 $114K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 2,383 2,376 $77K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 11,135 10,055 $71K
96110 Developmental screening, with scoring and documentation, per standardized instrument 1,811 1,529 $60K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,531 1,530 $60K
99222 Initial hospital care, per day, moderate complexity 1,140 1,118 $60K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,759 1,700 $57K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 739 727 $54K
99215 Prolong outpt/office vis 1,644 1,568 $52K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 425 147 $49K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 959 958 $48K
99308 Subsequent nursing facility care, per day, straightforward 3,604 723 $33K
45380 Colonoscopy, flexible; with biopsy, single or multiple 216 210 $27K
92551 2,915 2,912 $26K
99205 Prolong outpt/office vis 343 343 $25K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 557 554 $24K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 204 201 $24K
93000 3,455 3,397 $20K
99231 Subsequent hospital care, per day, straightforward or low complexity 1,243 643 $16K
90686 3,001 2,998 $15K
99309 Subsequent nursing facility care, per day, low to moderate complexity 884 355 $13K
Z1034 255 195 $13K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 95 95 $11K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 624 599 $11K
90670 1,179 1,171 $10K
59025 Fetal non-stress test 1,204 775 $8K
90651 454 453 $8K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,941 1,542 $7K
99459 526 509 $6K
90680 681 674 $6K
90633 700 698 $6K
93296 402 398 $6K
99152 578 568 $5K
90698 594 594 $5K
99255 70 68 $5K
93016 362 360 $4K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 155 155 $4K
90744 344 340 $3K
99239 Hospital discharge day management, more than 30 minutes 214 210 $3K
93294 379 373 $3K
20610 502 424 $3K
93018 369 367 $3K
90460 Immunization administration through 18 years of age via any route, first or only component 1,527 1,514 $2K
99283 Emergency department visit for the evaluation and management, moderate severity 102 101 $2K
99220 29 29 $2K
59514 13 13 $2K
99381 42 42 $2K
93308 117 115 $2K
90707 147 147 $2K
99383 28 28 $2K
90715 171 171 $1K
90734 159 159 $1K
90716 140 140 $1K
85018 1,223 1,214 $1K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 62 49 $1K
59425 486 407 $1K
93015 81 81 $1K
99221 70 68 $1K
93295 84 80 $1K
90696 116 116 $1K
90710 110 110 $990.00
90700 112 112 $972.00
80053 Comprehensive metabolic panel 3,668 3,198 $970.16
90656 138 138 $965.03
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 13 13 $936.90
85025 Blood count; complete (CBC), automated, and automated differential WBC count 4,438 3,605 $856.02
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 672 657 $824.60
71046 Radiologic examination, chest; 2 views 450 444 $713.56
99238 Hospital discharge day management, 30 minutes or less 29 29 $687.32
90461 637 632 $648.00
99451 52 52 $626.75
97803 121 101 $592.91
90648 65 65 $576.00
90697 61 60 $549.00
93321 64 61 $449.62
36415 Collection of venous blood by venipuncture 10,817 10,144 $440.17
S9445 Patient education, not otherwise classified, non-physician provider, individual, per session 52 44 $353.22
59430 12 12 $302.40
96151 33 30 $185.02
73562 28 26 $182.52
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,739 1,724 $174.30
1036F 425 418 $140.90
0298T 14 13 $129.54
93325 92 89 $128.10
90653 82 82 $126.70
93288 13 13 $114.18
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 139 122 $58.28
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 821 779 $43.38
73560 49 40 $28.43
83615 190 170 $26.76
96127 24 24 $19.65
99442 413 398 $18.67
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 12 12 $11.58
83036 Hemoglobin; glycosylated (A1C) 676 671 $8.45
81003 358 350 $6.88
99173 731 731 $3.12
36416 166 166 $0.00
3074F 332 322 $0.00
96161 278 273 $0.00
99443 33 31 $0.00
G0008 Administration of influenza virus vaccine 99 99 $0.00
87110 45 45 $0.00
99441 190 184 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 146 144 $0.00
87070 15 15 $0.00
3079F 41 41 $0.00
82962 39 37 $0.00
H0049 Alcohol and/or drug screening 14 14 $0.00
0501F 15 15 $0.00
93351 13 13 $0.00
80048 Basic metabolic panel (calcium, ionized) 15 12 $0.00
81025 47 46 $0.00
81002 100 98 $0.00
90662 73 73 $0.00
80061 Lipid panel 731 712 $0.00
3078F 245 242 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 118 118 $0.00
0502F 358 318 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 420 206 $0.00
91320 18 18 $0.00
73030 13 12 $0.00
82652 13 13 $0.00
3077F 16 16 $0.00