Medicaid Provider Spending

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

CHILDREN'S HOSPITAL OF ORANGE COUNTY

NPI: 1780169524 · ORANGE, CA 92868 · Pediatric Adolescent Medicine Physician · NPI assigned 09/27/2018

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

Authorized official KELLY, MARK controls 20+ related entities in our dataset. Read more

$4.84M
Total Medicaid Paid
180,568
Total Claims
173,241
Beneficiaries
77
Codes Billed
2019-09
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKELLY, MARK (DIRECTOR, CS BUSINESS SERIVICES)
Parent OrganizationCHILDREN'S HOSPITAL OF ORANGE COUNTY
NPI Enumeration Date09/27/2018

Related Entities

Other providers sharing the same authorized official: KELLY, MARK

ProviderCityStateTotal Paid
ST. FRANCIS MEDICAL CENTER TRENTON NJ $30.60M
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC. MONTEBELLO CA $18.75M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $11.86M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $8.23M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $5.33M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $5.33M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $4.74M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $4.70M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $4.31M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $3.82M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $3.47M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $3.10M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $2.14M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $2.09M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.93M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.47M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.43M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.31M
CHILDREN'S HOSPITAL OF ORANGE COUNTY ORANGE CA $1.25M
CHILDREN'S HOSPITAL OF ORANGE ORANGE CA $998K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 6,010 $146K
2020 28,093 $914K
2021 34,990 $1.19M
2022 40,571 $1.34M
2023 47,640 $1.17M
2024 23,264 $90K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
96156 16,372 16,280 $1.16M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 31,298 29,041 $568K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 18,200 16,976 $487K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 4,919 4,881 $325K
G9920 Screening performed and negative 14,403 14,341 $299K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 5,685 5,649 $298K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 5,654 5,614 $263K
96110 Developmental screening, with scoring and documentation, per standardized instrument 3,626 2,628 $255K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 4,848 4,623 $165K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 2,667 2,628 $122K
92551 10,230 10,179 $115K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 578 574 $73K
90686 7,001 6,977 $61K
97802 3,231 3,176 $56K
87428 1,341 1,289 $48K
99383 611 611 $43K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 4,468 4,224 $40K
99384 364 364 $31K
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 1,057 1,009 $27K
99215 Prolong outpt/office vis 596 557 $25K
90670 2,768 2,753 $25K
90651 2,320 2,307 $25K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,571 1,295 $21K
90633 2,248 2,237 $20K
90698 2,009 2,006 $18K
90680 1,822 1,813 $16K
90620 1,008 1,002 $15K
90734 1,476 1,471 $14K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 3,457 3,352 $14K
96151 589 589 $13K
99382 216 215 $13K
G9919 Screening performed and positive and provision of recommendations 453 453 $13K
90715 1,311 1,304 $12K
90716 1,164 1,154 $11K
0072A 269 269 $11K
90710 1,160 1,154 $10K
90696 1,156 1,150 $10K
90744 1,095 1,092 $10K
90697 827 817 $10K
90707 998 990 $9K
99381 152 151 $9K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 662 649 $9K
0071A 221 221 $9K
96127 1,517 1,507 $7K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,674 1,659 $7K
90671 303 302 $6K
90619 652 646 $6K
90674 996 996 $6K
85018 2,428 2,415 $5K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 209 209 $4K
81000 1,122 1,080 $3K
90480 77 76 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 230 208 $3K
96150 107 107 $2K
0002A 53 53 $2K
0001A 46 46 $2K
99174 144 134 $2K
90700 163 161 $1K
17110 13 13 $1K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 59 59 $1K
91321 25 25 $1K
83655 84 84 $945.00
69210 32 31 $686.94
0112A 16 16 $640.00
90661 536 536 $595.00
0073A 13 13 $270.00
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 20 20 $261.80
90672 31 31 $189.00
69209 28 28 $150.02
90621 12 12 $108.00
86308 15 13 $49.39
90656 12 12 $9.00
90460 Immunization administration through 18 years of age via any route, first or only component 815 757 $0.00
90461 316 283 $0.00
99173 549 523 $0.00
99188 13 13 $0.00
S9451 Exercise classes, non-physician provider, per session 1,157 1,108 $0.00