Medicaid Provider Spending

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

SUSANVILLE INDIAN RANCHERIA

NPI: 1770564049 · SUSANVILLE, CA 96130 · Federally Qualified Health Center (FQHC) · NPI assigned 11/14/2005

$16.23M
Total Medicaid Paid
42,665
Total Claims
32,191
Beneficiary Records
20
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBOVEE, DEANA (TRIBAL CHAIRMAN)
NPI Enumeration Date11/14/2005

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 5,358 $1.81M
2019 4,290 $1.47M
2020 3,801 $1.21M
2021 5,574 $1.78M
2022 7,424 $2.78M
2023 8,273 $3.44M
2024 7,945 $3.75M

Billing Codes

CodeDescriptionClaimsBene. RecordsTotal Paid
T1015 Clinic visit/encounter, all-inclusive 15,254 10,598 $8.88M
00003 Internal/system code - not a standard HCPCS code 12,370 8,993 $6.52M
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 1,790 1,544 $820K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6,112 5,269 $335.26
99173 14 14 $0.00
90832 Psychotherapy, 30 minutes with patient 1,493 735 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 13 13 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 735 696 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 32 30 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 12 12 $0.00
90837 Psychotherapy, 53 minutes with patient 150 87 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 26 26 $0.00
90460 Immunization administration through 18 years of age via any route, first or only component 13 12 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 13 12 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,536 4,057 $0.00
99000 25 22 $0.00
90834 Psychotherapy, 45 minutes with patient 17 15 $0.00
92551 17 17 $0.00
36415 Collection of venous blood by venipuncture 29 27 $0.00
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 14 12 $0.00