Medicaid Provider Spending

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

MID-ATLANTIC PAIN INSTITUTE, P.A.

NPI: 1831148410 · NEWARK, DE 19702 · Interventional Pain Medicine Physician · NPI assigned 05/09/2006

$959K
Total Medicaid Paid
174,068
Total Claims
103,087
Beneficiaries
46
Codes Billed
2018-01
First Month
2022-08
Last Month

Provider Details

Authorized OfficialFALCO, FRANK (MEDICAL DIRECTOR)
NPI Enumeration Date05/09/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 63,552 $220K
2019 97,384 $278K
2020 7,824 $206K
2021 3,957 $171K
2022 1,351 $83K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 19,742 12,259 $512K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6,149 4,227 $194K
G0483 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed 4,224 3,507 $191K
99406 3,162 2,335 $12K
95923 142 120 $9K
96138 901 508 $8K
93922 127 108 $6K
95886 193 154 $5K
95921 143 121 $5K
95911 26 24 $3K
76942 327 210 $3K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 224 163 $3K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 155 119 $2K
62370 109 65 $2K
G8950 Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented 13,111 7,552 $1K
96103 1,970 1,408 $875.68
80305 602 431 $865.17
95913 119 93 $752.78
20553 62 26 $525.03
G9578 Documentation of signed opioid treatment agreement at least once during opioid therapy 2,130 1,321 $517.00
4004F 6,742 3,873 $291.58
96127 98 57 $257.11
96101 195 139 $245.89
93000 176 154 $237.51
G9584 Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy 12,983 7,216 $40.71
G0481 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed 77 58 $24.22
S0020 Injection, bupivicaine hydrochloride, 30 ml 68 33 $9.52
99000 64 47 $4.50
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 15,138 8,766 $0.00
G8730 Pain assessment documented as positive using a standardized tool and a follow-up plan is documented 14,689 8,426 $0.00
G8783 Normal blood pressure reading documented, follow-up not required 1,604 925 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 12,643 7,242 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 12,006 6,919 $0.00
G8731 Pain assessment using a standardized tool is documented as negative, no follow-up plan required 19 13 $0.00
A4550 Surgical trays 115 68 $0.00
G8400 Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given 37 27 $0.00
A4220 Refill kit for implantable infusion pump 37 26 $0.00
G9906 Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) 4,822 2,452 $0.00
G9583 Patients prescribed opiates for longer than six weeks 12,264 6,710 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 2,563 1,431 $0.00
1036F 8,563 5,054 $0.00
G9902 Patient screened for tobacco use and identified as a tobacco user 5,431 2,844 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 7,375 4,220 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 2,167 1,274 $0.00
1006F 554 346 $0.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 20 16 $0.00