Medicaid Provider Spending

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

PRESTIGE MEDICAL CLINIC AND URGENT CARE INC

NPI: 1801444708 · POMONA, CA 91767 · Family Medicine Physician · NPI assigned 09/03/2019

$93K
Total Medicaid Paid
5,130
Total Claims
4,807
Beneficiaries
13
Codes Billed
2022-04
First Month
2024-11
Last Month

Provider Details

Authorized OfficialODURO-BURTON, EMY (CEO)
NPI Enumeration Date09/03/2019

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 14 $211.89
2023 478 $9K
2024 4,638 $84K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,184 1,164 $52K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,093 958 $25K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 443 425 $7K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 49 49 $2K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 313 270 $2K
99000 959 902 $2K
36415 Collection of venous blood by venipuncture 586 553 $568.65
81002 207 199 $565.17
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 117 116 $560.69
93000 16 15 $395.74
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 54 52 $320.79
81025 95 91 $277.30
81005 14 13 $7.00