Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › DC › WASHINGTON › CHILDREN'S HOSPITAL

CHILDREN'S HOSPITAL

NPI: 1780800128 · WASHINGTON, DC 20010 · Pediatrics Physician · NPI assigned 04/17/2007

$115.27M
Total Medicaid Paid
1,906,386
Total Claims
1,683,381
Beneficiaries
292
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialNELSON, PHILLICIA (REIMBURSEMENT OFFICER)
NPI Enumeration Date04/17/2007

Related Entities

Other providers sharing the same authorized official: NELSON, PHILLICIA

ProviderCityStateTotal Paid
CHILDREN'S HOSPITAL WASHINGTON DC $242.96M
HOSPITAL FOR SICK CHILDREN WASHINGTON DC $4.66M
CHILDREN'S HOSPITAL WASHINGTON DC $2.75M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 205,693 $10.59M
2019 202,631 $9.69M
2020 233,412 $13.74M
2021 310,796 $18.76M
2022 327,549 $20.41M
2023 329,140 $22.22M
2024 297,165 $19.85M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 264,371 251,236 $16.19M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 140,880 133,632 $12.62M
99283 Emergency department visit for the evaluation and management, moderate severity 177,574 171,031 $10.89M
99284 Emergency department visit for the evaluation and management, high severity 102,055 97,282 $10.48M
99215 Prolong outpt/office vis 65,976 60,746 $8.23M
99472 Subsequent inpatient pediatric critical care, per day, 2-5 years 21,424 5,434 $6.50M
99233 Prolong inpt eval add15 m 66,544 25,965 $5.79M
99244 Office or other outpatient consultation, moderate to high complexity 19,396 18,502 $2.78M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 20,795 19,959 $2.73M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 13,686 5,451 $2.70M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 32,750 31,483 $2.10M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 31,696 30,438 $2.02M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 13,364 12,584 $1.92M
99243 19,380 18,393 $1.76M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 19,775 18,921 $1.64M
T2022 Case management, per month 5,444 5,215 $1.04M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 18,106 17,105 $1.01M
99282 Emergency department visit for the evaluation and management, low to moderate severity 23,437 22,566 $991K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 19,353 17,100 $974K
90460 Immunization administration through 18 years of age via any route, first or only component 42,151 38,954 $895K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 12,108 11,537 $826K
99238 Hospital discharge day management, 30 minutes or less 13,839 12,919 $763K
70551 Magnetic resonance imaging, brain; without contrast material 9,884 9,273 $720K
99460 8,783 8,159 $718K
95720 4,465 3,050 $713K
99245 4,101 3,819 $691K
99205 Prolong outpt/office vis 4,241 4,078 $668K
99480 Subsequent intensive care, per day, low birth weight infant 7,276 1,969 $665K
99232 Subsequent hospital care, per day, moderate complexity 10,561 5,906 $632K
42820 Tonsillectomy and adenoidectomy; younger than age 12 2,547 2,410 $596K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 4,222 3,981 $560K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 7,888 7,377 $539K
99223 Prolong inpt eval add15 m 3,079 2,898 $539K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 15,051 14,374 $525K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 6,107 5,868 $440K
70450 Computed tomography, head or brain; without contrast material 10,792 9,654 $413K
71045 Radiologic examination, chest; single view 66,997 39,234 $378K
88305 Level IV - Surgical pathology, gross and microscopic examination 14,365 5,868 $374K
93320 20,918 18,158 $344K
71046 Radiologic examination, chest; 2 views 38,249 36,419 $331K
90791 Psychiatric diagnostic evaluation 2,641 2,522 $321K
90834 Psychotherapy, 45 minutes with patient 4,241 2,917 $311K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 49,353 42,035 $307K
76705 Ultrasound, abdominal, real time with image documentation; limited 12,415 11,412 $286K
90461 11,811 11,187 $269K
99254 1,963 1,833 $262K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 3,620 3,411 $251K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger 823 247 $239K
76770 8,273 7,874 $235K
95810 Polysomnography; sleep staging with 4 or more additional parameters 2,125 2,057 $229K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 1,163 1,025 $214K
90837 Psychotherapy, 53 minutes with patient 1,909 1,448 $214K
01922 1,026 967 $213K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 4,200 3,963 $207K
92015 Determination of refractive state 15,113 14,387 $206K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 3,292 2,852 $197K
99239 Hospital discharge day management, more than 30 minutes 2,829 2,664 $188K
00170 Anesthesia for intraoral procedures, including biopsy 1,201 1,115 $186K
96127 64,657 61,779 $182K
92551 19,233 18,404 $178K
99288 4,720 3,982 $173K
90832 Psychotherapy, 30 minutes with patient 2,571 2,309 $154K
99471 207 163 $153K
92060 5,065 4,822 $149K
93325 31,209 26,540 $145K
99462 3,860 3,011 $143K
99242 2,070 1,941 $143K
90847 Family psychotherapy with the patient present, 50 minutes 1,659 1,050 $137K
96112 1,259 1,228 $132K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 12,530 11,997 $132K
95951 535 390 $117K
95782 1,040 1,012 $112K
99220 679 644 $110K
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) 8,499 8,111 $109K
76700 Ultrasound, abdominal, real time with image documentation; complete 3,195 3,047 $101K
99417 Prolong home eval add 15m 2,874 2,565 $99K
90839 1,183 1,098 $94K
74022 9,312 5,851 $92K
96156 1,766 1,594 $91K
74018 13,916 12,147 $91K
96113 633 619 $89K
99255 566 506 $86K
90670 1,102 1,095 $81K
76825 1,233 1,068 $78K
54150 1,029 993 $78K
74021 7,391 6,895 $75K
D2930 Prefabricated stainless steel crown - primary tooth 251 156 $75K
94010 10,018 9,541 $75K
99476 235 99 $73K
99174 14,715 13,997 $68K
90686 5,996 5,954 $65K
D0191 3,297 3,169 $62K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 1,128 1,013 $58K
90472 Immunization administration, each additional vaccine (list separately) 4,282 4,067 $58K
D1120 Prophylaxis - child 1,215 1,207 $57K
99173 23,606 22,630 $57K
99222 Initial hospital care, per day, moderate complexity 437 410 $53K
95718 502 463 $52K
D7140 Extraction, erupted tooth or exposed root 476 310 $52K
80502 1,123 940 $50K
90651 377 375 $46K
88108 2,887 2,042 $45K
73610 6,466 6,107 $45K
16020 1,056 891 $44K
99479 Subsequent intensive care, per day, very low birth weight infant 460 157 $44K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 820 775 $43K
99464 834 782 $43K
99253 446 421 $42K
73090 6,666 5,998 $42K
76506 1,883 1,424 $42K
73590 6,327 5,688 $40K
96110 Developmental screening, with scoring and documentation, per standardized instrument 3,580 3,395 $40K
88307 620 525 $38K
D0120 Periodic oral evaluation - established patient 1,066 1,064 $37K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 425 414 $37K
99281 Emergency department visit for the evaluation and management, self-limited or minor 1,619 1,543 $36K
D1206 Topical application of fluoride varnish 1,243 1,236 $36K
0071A 971 954 $35K
99236 Prolong inpt eval add15 m 179 139 $34K
76000 2,413 2,271 $33K
80503 2,020 1,713 $32K
95819 724 645 $32K
0072A 789 736 $30K
73630 4,386 4,175 $30K
93976 792 737 $30K
99231 Subsequent hospital care, per day, straightforward or low complexity 1,001 663 $30K
95251 996 951 $30K
72081 3,009 2,900 $29K
88300 6,600 4,505 $29K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 244 236 $29K
93000 2,074 1,935 $28K
90677 338 331 $28K
90698 825 820 $27K
76827 1,233 1,069 $27K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 578 565 $26K
88304 2,372 2,246 $26K
88188 579 540 $24K
D0150 Comprehensive oral evaluation - new or established patient 284 276 $21K
90710 170 169 $21K
73080 3,125 2,840 $21K
D0140 Limited oral evaluation - problem focused 396 389 $20K
96167 845 629 $19K
72170 2,716 2,564 $19K
96116 117 109 $18K
77072 2,643 2,566 $18K
92201 1,015 844 $16K
D0272 Bitewings - two radiographic images 404 402 $16K
69210 631 589 $16K
90792 Psychiatric diagnostic evaluation with medical services 123 115 $16K
99188 1,679 1,610 $16K
99292 173 80 $15K
88342 584 506 $15K
43775 18 12 $15K
85060 1,118 1,025 $15K
76536 674 637 $15K
73130 2,027 1,896 $14K
73100 2,356 2,191 $14K
90734 164 164 $13K
31575 251 214 $13K
70486 298 282 $12K
D1351 Sealant - per tooth 318 118 $12K
73140 2,164 2,000 $12K
94060 1,064 1,006 $12K
77001 511 439 $11K
90716 104 104 $11K
0001A 348 318 $11K
72082 920 886 $10K
90633 457 456 $10K
95816 221 217 $9K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 58 46 $9K
42830 64 61 $9K
90680 227 227 $9K
0002A 290 228 $9K
99221 114 109 $8K
00920 65 62 $8K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 550 491 $8K
93888 381 305 $8K
92587 460 434 $8K
D0220 Intraoral - periapical first radiographic image 379 369 $8K
51728 113 101 $7K
90707 93 93 $6K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 79 79 $6K
96111 51 51 $6K
94621 91 83 $6K
92552 347 338 $5K
99381 56 56 $5K
49452 48 47 $5K
74177 Computed tomography, abdomen and pelvis; with contrast material 70 68 $5K
D0330 Panoramic radiographic image 58 58 $5K
76775 180 174 $5K
90696 125 125 $4K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 56 56 $4K
74712 39 39 $4K
90656 408 404 $4K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 127 122 $4K
72141 53 52 $4K
70544 103 87 $4K
73560 581 548 $4K
96158 164 126 $4K
70360 552 515 $3K
90744 173 173 $3K
73521 424 399 $3K
99217 47 45 $3K
54161 24 24 $3K
73070 535 503 $3K
99219 26 26 $3K
99241 96 95 $3K
73564 377 351 $3K
76937 278 238 $3K
93304 100 79 $3K
73562 354 336 $3K
D0240 94 93 $3K
0124A 71 70 $3K
93227 184 183 $3K
51797 111 99 $3K
0154A 70 70 $2K
51784 121 105 $2K
0052A 79 60 $2K
72156 12 12 $2K
74181 28 26 $2K
72157 12 12 $2K
0051A 89 65 $2K
96170 52 46 $2K
88341 69 38 $2K
D0230 Intraoral - periapical each additional radiographic image 119 117 $2K
90620 14 14 $2K
45380 Colonoscopy, flexible; with biopsy, single or multiple 13 12 $2K
D2391 Resin-based composite - one surface, posterior, primary or permanent 17 12 $2K
90480 78 76 $2K
90715 113 112 $2K
0081A 42 42 $2K
99252 26 24 $2K
72146 25 25 $2K
72158 14 12 $2K
77080 185 180 $2K
73552 249 225 $2K
93321 251 207 $2K
78708 32 28 $2K
76882 81 75 $2K
99383 14 14 $2K
76870 72 67 $2K
99354 14 12 $2K
99177 649 639 $2K
88312 73 67 $1K
74240 52 52 $1K
00635 14 12 $1K
76885 63 57 $1K
90836 14 12 $1K
96132 12 12 $1K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 19 16 $1K
99418 Prolong nursin fac eval 15m 31 12 $1K
94664 71 65 $1K
76390 18 14 $967.70
36415 Collection of venous blood by venipuncture 459 448 $913.31
0074A 28 28 $900.62
94729 87 83 $766.33
90474 80 80 $737.39
99051 10,304 9,953 $705.58
85097 18 15 $693.20
99358 Prolong nursin fac eval 15m 129 74 $678.56
92002 14 14 $676.36
96160 1,728 1,676 $660.81
62322 12 12 $659.16
82272 271 213 $624.60
88313 85 52 $621.36
92133 27 26 $586.51
90697 133 131 $518.91
93886 12 12 $504.37
92202 36 25 $403.65
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 39 36 $378.54
73030 41 41 $338.73
90681 16 16 $312.00
11900 12 12 $291.36
94774 14 14 $268.50
99457 62 38 $218.50
90785 18 16 $196.02
73000 27 25 $182.78
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 15 15 $167.65
90619 98 98 $157.50
93356 14 13 $140.57
88311 19 15 $137.21
96161 62 54 $130.08
73110 14 12 $105.52
99374 147 135 $88.80
73060 13 12 $82.70
80053 Comprehensive metabolic panel 12 12 $35.17
99000 54 54 $29.87
36416 24 14 $0.04
D1354 87 30 $0.00
99375 262 255 $0.00
2015F 371 366 $0.00
96150 41 40 $0.00