Medicaid Provider Spending

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

RIVERBEND MEDICAL GROUP, INC.

NPI: 1841651197 · SPRINGFIELD, MA 01104 · Psychologist · NPI assigned 03/15/2016

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

Authorized official HARRIS, JAMES controls 20+ related entities in our dataset. Read more

$38.70M
Total Medicaid Paid
1,182,216
Total Claims
1,131,326
Beneficiaries
276
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHARRIS, JAMES (REGIONAL DIRECTOR OF REIMBURSEMENT)
NPI Enumeration Date03/15/2016

Related Entities

Other providers sharing the same authorized official: HARRIS, JAMES

ProviderCityStateTotal Paid
SAINT FRANCIS HOSPITAL AND MEDICAL CENTER HARTFORD CT $266.39M
SAINT MARY'S HOSPITAL, INC. WATERBURY CT $163.27M
THE MERCY HOSPITAL INC SPRINGFIELD MA $98.92M
TRINITY HEALTH OF NEW ENGLAND PROVIDER NETWORK ORGANIZATION INC HARTFORD CT $41.97M
SYSTEM COORDINATED SERVICES, INC SPRINGFIELD MA $18.54M
BRIGHTSIDE INC SPRINGFIELD MA $11.41M
THE MERCY HOSPITAL INC HOLYOKE MA $10.93M
MERCY INPATIENT MEDICAL ASSOCIATES INC. SPRINGFIELD MA $6.96M
STATE OF NEW YORK COMPTROLLERS OFFICE BUFFALO NY $6.05M
SAINT FRANCIS CARE MEDICAL GROUP, PC HARTFORD CT $2.00M
SAINT FRANCIS HOSPITAL AND MEDICAL CENTER HARTFORD CT $1.42M
PIONEER VALLEY CARDIOLOGY ASSOCIATES, INC SPRINGFIELD MA $1.31M
MERCY MEDICAL GROUP, INC. SPRINGFIELD MA $1.08M
SAINT FRANCIS HOSPITAL AND MEDICAL CENTER HARTFORD CT $382K
PRATER VOLUNTEER RESCUE SQUAD INC GRUNDY VA $331K
DIABETES AND LIFESTYLE MANAGEMENT, LLC DERRY NH $273K
MERCY SPECIALIST PHYSICIANS INC SPRINGFIELD MA $101K
HEALTH ACCESS, INC. CLARKSBURG WV $85K
GIBSON COUNTY PODIATRY LLC MILAN TN $83K
SAINT FRANCIS HOSPITAL AND MEDICAL CENTER HARTFORD CT $45K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 263,339 $7.95M
2019 191,506 $7.89M
2020 143,395 $6.27M
2021 143,732 $5.89M
2022 144,071 $5.44M
2023 168,454 $3.47M
2024 127,719 $1.80M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 281,441 272,594 $14.04M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 190,129 184,567 $7.36M
90460 Immunization administration through 18 years of age via any route, first or only component 46,307 45,879 $1.45M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 19,231 19,195 $1.17M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 19,421 18,448 $1.13M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 18,290 18,255 $1.07M
77067 Screening mammography, bilateral, including computer-aided detection 12,921 12,504 $1.01M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 10,914 10,818 $941K
96110 Developmental screening, with scoring and documentation, per standardized instrument 76,579 75,574 $790K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 14,616 14,523 $774K
S0302 Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) 78,428 77,589 $683K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 10,464 10,442 $641K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 5,992 5,980 $392K
92551 38,494 38,419 $364K
90834 Psychotherapy, 45 minutes with patient 3,334 2,040 $358K
76830 Ultrasound, transvaginal 3,745 3,499 $301K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 4,117 3,835 $292K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 4,174 4,160 $286K
71046 Radiologic examination, chest; 2 views 12,424 11,748 $218K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 4,624 4,515 $183K
98940 9,013 3,059 $179K
77063 Screening digital breast tomosynthesis, bilateral 6,590 6,364 $178K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 11,032 10,875 $172K
72110 5,416 5,178 $153K
90832 Psychotherapy, 30 minutes with patient 2,092 1,231 $137K
94060 6,865 4,606 $132K
90674 7,179 6,911 $128K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 2,717 2,713 $124K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 9,494 9,400 $117K
20610 3,780 3,242 $117K
94729 6,472 4,337 $116K
99215 Prolong outpt/office vis 1,620 1,596 $111K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,387 4,297 $106K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 1,372 1,125 $106K
73630 5,841 4,622 $99K
97802 1,056 1,009 $97K
99051 5,789 5,707 $96K
76536 1,346 1,292 $95K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 713 711 $92K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 712 589 $92K
94727 6,034 4,046 $85K
99443 4,878 4,497 $84K
17110 1,235 1,174 $84K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,376 1,350 $80K
11721 4,826 4,718 $74K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 2,905 2,899 $73K
95886 804 761 $72K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 2,867 2,861 $72K
76700 Ultrasound, abdominal, real time with image documentation; complete 1,022 974 $71K
80061 Lipid panel 9,026 8,949 $64K
43775 97 97 $62K
64483 693 691 $61K
73562 2,583 2,378 $60K
90791 Psychiatric diagnostic evaluation 414 359 $57K
76642 1,034 939 $57K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 860 854 $52K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 3,590 3,300 $51K
73030 2,898 2,668 $51K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 6,717 4,590 $51K
73564 1,771 1,491 $49K
62323 496 488 $48K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 415 412 $48K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 373 317 $43K
76801 528 442 $42K
72050 1,431 1,369 $40K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 405 348 $38K
76813 481 408 $38K
84443 Thyroid stimulating hormone (TSH) 3,346 3,316 $35K
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk 295 288 $35K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 532 515 $35K
80053 Comprehensive metabolic panel 6,079 6,028 $35K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 342 323 $32K
83036 Hemoglobin; glycosylated (A1C) 6,132 6,086 $32K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 6,239 6,141 $32K
95911 216 199 $30K
81025 4,727 4,619 $30K
11102 409 401 $30K
76705 Ultrasound, abdominal, real time with image documentation; limited 568 550 $30K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 702 702 $29K
99442 1,582 1,465 $25K
80048 Basic metabolic panel (calcium, ionized) 5,262 5,138 $24K
11056 1,079 1,040 $24K
71250 327 317 $23K
95811 65 62 $21K
73130 1,036 927 $21K
45380 Colonoscopy, flexible; with biopsy, single or multiple 273 272 $21K
99205 Prolong outpt/office vis 138 137 $20K
97803 564 509 $20K
98941 Chiropractic manipulative treatment; spinal, 3-4 regions 711 243 $20K
80305 2,314 1,930 $19K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 740 725 $19K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 478 477 $19K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 70 69 $18K
11100 243 242 $18K
93975 87 80 $17K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 4,644 4,421 $16K
93015 274 272 $15K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 311 204 $15K
95251 1,191 1,154 $14K
20550 416 393 $14K
80050 General health panel 819 811 $13K
76819 Fetal biophysical profile; without non-stress testing 215 164 $13K
77065 Tomosynthesis, mammo 212 202 $13K
95117 1,621 531 $12K
99460 117 117 $12K
85027 2,016 1,999 $11K
90756 631 629 $11K
93000 1,023 1,014 $10K
96900 691 150 $10K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 70 70 $10K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 134 118 $9K
74176 Computed tomography, abdomen and pelvis; without contrast material 91 88 $9K
87210 1,871 1,855 $8K
G0127 Trimming of dystrophic nails, any number 907 901 $8K
J1040 Injection, methylprednisolone acetate, 80 mg 1,365 1,327 $8K
94726 419 275 $8K
86780 596 594 $7K
87808 686 684 $7K
87081 1,055 1,050 $7K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 183 173 $7K
11750 85 69 $6K
36478 13 12 $6K
90792 Psychiatric diagnostic evaluation with medical services 47 47 $6K
94618 497 348 $6K
95909 69 67 $6K
0011A 154 154 $6K
82962 3,616 3,458 $6K
99238 Hospital discharge day management, 30 minutes or less 111 111 $6K
73110 279 234 $6K
99232 Subsequent hospital care, per day, moderate complexity 241 117 $6K
94010 282 238 $6K
73502 256 250 $6K
90670 1,288 1,283 $5K
99223 Prolong inpt eval add15 m 91 89 $5K
0012A 129 129 $5K
90715 219 215 $5K
85610 3,167 1,901 $5K
73610 229 223 $5K
37765 27 24 $5K
90662 323 308 $4K
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 473 459 $4K
99403 75 74 $4K
59025 Fetal non-stress test 169 119 $4K
29848 14 14 $4K
77066 Tomosynthesis, mammo 50 49 $4K
62321 55 55 $4K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 253 243 $4K
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit 213 210 $4K
82043 1,189 1,184 $4K
82570 1,174 1,169 $3K
98968 182 173 $3K
51701 118 117 $3K
90661 130 130 $3K
97597 287 192 $3K
99233 Prolong inpt eval add15 m 78 33 $2K
87634 48 46 $2K
99386 25 24 $2K
96127 581 569 $2K
86803 200 198 $2K
ATP14 1,252 1,234 $2K
73140 109 89 $2K
77080 196 190 $2K
ATP17 1,332 1,331 $2K
43235 26 26 $2K
80074 44 43 $2K
86140 576 570 $2K
72070 73 72 $2K
84460 638 636 $2K
84450 639 637 $2K
95024 31 30 $2K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 1,719 1,685 $2K
74177 Computed tomography, abdomen and pelvis; with contrast material 28 28 $1K
99397 14 14 $1K
90651 610 608 $1K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 818 705 $1K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 76 76 $1K
90694 200 180 $1K
73221 39 39 $1K
84439 178 175 $1K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 49 49 $1K
81001 582 566 $1K
ATP08 1,288 1,222 $1K
29540 95 91 $1K
70551 Magnetic resonance imaging, brain; without contrast material 24 24 $1K
98967 74 74 $1K
85651 543 538 $1K
ATP11 873 873 $1K
82607 119 117 $1K
99188 44 44 $991.90
72141 25 25 $979.58
73565 51 48 $974.56
90480 27 26 $966.64
ATP03 448 447 $947.28
11730 13 13 $864.90
93971 14 14 $852.59
20611 12 12 $745.91
20526 13 13 $690.70
G0008 Administration of influenza virus vaccine 552 542 $591.59
70450 Computed tomography, head or brain; without contrast material 27 27 $590.11
83550 97 95 $570.24
76770 12 12 $486.12
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) 133 130 $459.91
99173 248 248 $424.87
82465 84 84 $377.83
84153 24 24 $342.51
82565 180 178 $323.38
99222 Initial hospital care, per day, moderate complexity 13 13 $300.55
99177 90 90 $288.30
83970 17 17 $285.67
90688 1,415 1,413 $272.90
J1010 Injection, methylprednisolone acetate, 1 mg 27 27 $262.82
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 15 13 $257.16
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 224 207 $256.25
71045 Radiologic examination, chest; single view 68 56 $234.32
99493 160 160 $213.74
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 17 17 $202.13
ATP15 71 71 $196.02
74220 12 12 $172.46
ATP07 75 74 $160.17
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) 12 12 $145.28
95012 64 58 $143.18
86705 13 13 $139.37
94762 13 13 $133.70
81002 56 56 $130.31
90472 Immunization administration, each additional vaccine (list separately) 244 244 $126.44
80051 33 33 $125.68
87340 13 13 $122.28
86431 30 30 $118.05
86706 12 12 $113.12
86580 14 14 $92.72
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 13 13 $82.29
90686 867 866 $71.09
84520 45 45 $70.69
J2175 Injection, meperidine hydrochloride, per 100 mg 50 50 $63.93
80076 15 14 $62.99
84100 42 41 $40.16
ATP13 191 191 $32.67
82310 25 25 $21.03
90685 582 582 $19.52
99000 15 14 $13.00
J2250 Injection, midazolam hydrochloride, per 1 mg 25 25 $12.57
ATP05 12 12 $8.06
3074F 1,265 1,230 $0.00
90698 627 626 $0.00
90680 1,269 1,259 $0.00
3048F 1,515 1,447 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 671 656 $0.00
90656 177 176 $0.00
3061F 441 423 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 916 833 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 82 75 $0.00
90716 611 609 $0.00
90744 362 361 $0.00
90723 41 41 $0.00
90474 25 25 $0.00
99494 12 12 $0.00
3060F 42 41 $0.00
90696 26 26 $0.00
G8599 Aspirin or another antiplatelet therapy not used, reason not given 12 12 $0.00
4040F 4,272 4,121 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 24,462 23,672 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 12,946 12,532 $0.00
90633 739 733 $0.00
G8484 Influenza immunization was not administered, reason not given 14,110 13,655 $0.00
90461 3,016 3,011 $0.00
4004F 1,073 990 $0.00
3078F 1,873 1,810 $0.00
G8400 Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given 103 98 $0.00
90734 436 432 $0.00
90648 127 127 $0.00
90707 545 544 $0.00
90687 55 55 $0.00
90714 30 30 $0.00
90700 25 25 $0.00
3045F 13 13 $0.00
G8598 Aspirin or another antiplatelet therapy used 17 16 $0.00