Medicaid Provider Spending

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

PROVIDENCE MEDICAL FOUNDATION

NPI: 1871607762 · BREA, CA 92821 · Radiology Clinic/Center · NPI assigned 08/18/2006

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

Authorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more

$52.59M
Total Medicaid Paid
1,646,014
Total Claims
1,434,221
Beneficiaries
331
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialANDERSON, DONALD (ASSISTANT SECRETARY OF ENROLLMENTS)
NPI Enumeration Date08/18/2006

Related Entities

Other providers sharing the same authorized official: ANDERSON, DONALD

ProviderCityStateTotal Paid
PROVIDENCE HEALTH & SERVICES WASHINGTON ANCHORAGE AK $161.45M
KADLEC REGIONAL MEDICAL CENTER RICHLAND WA $151.60M
SWEDISH EDMONDS EDMONDS WA $30.06M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC EUREKA CA $28.68M
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA TORRANCE CA $27.29M
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA SAN PEDRO CA $24.26M
PROVIDENCE HEALTH & SERVICES - WASHINGTON TUKWILA WA $21.98M
SWEDISH HEALTH SERVICES SEATTLE WA $21.06M
PROVIDENCE HEALTH & SERVICES WASHINGTON KODIAK AK $11.39M
SWEDISH HEALTH SERVICES SEATTLE WA $11.08M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC FORTUNA CA $8.55M
COLLABRIA CARE NAPA CA $8.20M
PROVIDENCE HEALTH & SERVICES OREGON SEASIDE OR $8.01M
PROVIDENCE HEALTH & SERVICES- WASHINGTON SPOKANE WA $8.01M
HOSPICE OF LUBBOCK INC LUBBOCK TX $6.48M
PROVIDENCE SAINT JOHN'S HEALTH CENTER SANTA MONICA CA $5.52M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.55M
COLLABRIA CARE NAPA CA $4.05M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.01M
METHODIST HOSPITAL PLAINVIEW TEXAS PLAINVIEW TX $4.00M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 112,651 $4.35M
2019 177,882 $6.14M
2020 173,958 $6.09M
2021 211,440 $7.12M
2022 266,550 $8.41M
2023 352,416 $9.86M
2024 351,117 $10.62M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 249,770 236,807 $7.23M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 242,541 230,384 $4.85M
99284 Emergency department visit for the evaluation and management, high severity 38,251 37,613 $3.12M
H1001 Prenatal care, at-risk enhanced service; antepartum management 31,731 21,070 $2.90M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 24,718 11,462 $2.84M
99232 Subsequent hospital care, per day, moderate complexity 81,866 32,685 $2.76M
99233 Prolong inpt eval add15 m 62,153 26,018 $2.62M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 31,365 30,828 $2.46M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 28,068 27,927 $1.54M
S9083 Global fee urgent care centers 27,856 25,047 $1.50M
99283 Emergency department visit for the evaluation and management, moderate severity 26,717 26,194 $1.41M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 15,720 15,567 $1.24M
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 92,188 81,726 $1.19M
96156 12,770 12,461 $1.07M
99215 Prolong outpt/office vis 19,261 17,898 $1.05M
99223 Prolong inpt eval add15 m 14,584 13,889 $1.02M
59425 10,301 7,308 $852K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 16,673 16,202 $606K
99222 Initial hospital care, per day, moderate complexity 9,233 8,863 $600K
J0585 Injection, onabotulinumtoxina, 1 unit 802 574 $556K
95144 703 645 $523K
99239 Hospital discharge day management, more than 30 minutes 11,169 10,719 $453K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 10,417 10,187 $422K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 9,565 9,029 $404K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,541 1,483 $395K
77067 Screening mammography, bilateral, including computer-aided detection 2,841 2,839 $388K
99282 Emergency department visit for the evaluation and management, low to moderate severity 11,514 11,347 $371K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 7,418 7,258 $369K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 16,184 15,938 $361K
99205 Prolong outpt/office vis 3,317 3,281 $348K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 2,441 2,417 $277K
93000 11,344 11,016 $273K
96110 Developmental screening, with scoring and documentation, per standardized instrument 4,217 4,098 $258K
Z1034 4,747 3,266 $258K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,865 1,681 $238K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 398 371 $191K
99244 Office or other outpatient consultation, moderate to high complexity 1,279 1,270 $180K
95811 746 740 $179K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 12,441 12,140 $177K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 5,125 5,109 $165K
99243 1,429 1,416 $155K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 2,105 1,737 $145K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 194 191 $137K
99238 Hospital discharge day management, 30 minutes or less 3,744 3,666 $135K
90686 14,137 13,780 $126K
G9920 Screening performed and negative 9,300 9,249 $122K
H1000 Prenatal care, at-risk assessment 695 671 $116K
59430 1,274 1,213 $112K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 973 933 $107K
92551 8,938 8,721 $101K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 600 588 $99K
45380 Colonoscopy, flexible; with biopsy, single or multiple 277 262 $92K
96151 4,086 3,956 $91K
95117 5,135 2,444 $88K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 3,314 1,660 $85K
G6015 Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session 586 102 $84K
99255 823 798 $79K
71046 Radiologic examination, chest; 2 views 3,350 3,315 $76K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 35,563 34,673 $75K
90670 8,293 7,942 $72K
99245 437 431 $70K
99231 Subsequent hospital care, per day, straightforward or low complexity 3,234 1,524 $69K
59025 Fetal non-stress test 5,026 3,359 $67K
99254 854 845 $60K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 1,084 1,054 $58K
95810 Polysomnography; sleep staging with 4 or more additional parameters 237 237 $58K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 298 291 $53K
90723 5,975 5,695 $53K
77427 678 277 $49K
17110 571 529 $47K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 16,851 9,039 $46K
99221 1,785 1,716 $45K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 630 625 $42K
90633 5,150 5,051 $42K
97530 Therapeutic activities, direct patient contact, each 15 minutes 2,914 1,865 $41K
90651 3,667 3,595 $41K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 508 508 $41K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 10,334 9,533 $41K
J2785 Injection, regadenoson, 0.1 mg 276 268 $40K
76700 Ultrasound, abdominal, real time with image documentation; complete 389 389 $39K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 4,137 3,578 $38K
76641 276 274 $37K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 408 376 $37K
90647 4,664 4,502 $37K
99309 Subsequent nursing facility care, per day, low to moderate complexity 4,435 2,525 $36K
73610 1,561 1,251 $36K
90837 Psychotherapy, 53 minutes with patient 314 268 $36K
90715 2,641 2,587 $36K
73110 1,496 1,143 $34K
93299 477 470 $30K
G9012 Other specified case management service not elsewhere classified 961 817 $28K
93298 813 792 $25K
90734 3,185 3,111 $24K
20553 298 289 $24K
93016 1,067 1,052 $24K
93297 981 955 $23K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 11,141 11,025 $23K
95806 123 122 $22K
90681 2,397 2,231 $22K
90700 2,443 2,391 $21K
90707 2,325 2,267 $21K
99308 Subsequent nursing facility care, per day, straightforward 1,957 1,565 $21K
90716 2,313 2,260 $21K
76642 229 225 $21K
76830 Ultrasound, transvaginal 265 265 $21K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 51 50 $20K
99000 6,153 5,735 $20K
97010 1,715 958 $20K
90710 2,397 2,347 $20K
77066 Tomosynthesis, mammo 119 119 $20K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 622 387 $20K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 134 134 $19K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 5,155 5,049 $19K
90696 2,104 2,061 $18K
80053 Comprehensive metabolic panel 1,875 1,762 $17K
96150 736 724 $17K
93018 967 962 $17K
73130 689 562 $16K
29075 128 105 $16K
20610 736 633 $16K
90620 984 958 $16K
99442 4,270 4,156 $16K
99385 252 252 $16K
59514 35 30 $16K
85018 8,870 8,652 $15K
73630 700 636 $15K
72100 461 461 $14K
99292 292 137 $14K
99460 205 200 $14K
83655 1,497 1,469 $14K
99383 317 307 $14K
99492 105 104 $14K
99493 184 182 $13K
76942 332 329 $13K
93015 147 145 $13K
97014 946 556 $13K
81002 18,456 17,939 $13K
90648 1,330 1,281 $12K
77336 366 150 $12K
93017 257 251 $12K
73562 476 438 $11K
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 3,958 3,822 $11K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 56 49 $11K
94729 483 480 $11K
90791 Psychiatric diagnostic evaluation 82 82 $11K
96375 Therapeutic injection; each additional sequential IV push 183 109 $11K
84443 Thyroid stimulating hormone (TSH) 723 716 $10K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 422 416 $10K
99497 94 92 $10K
73030 470 454 $10K
95911 42 40 $10K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 297 296 $9K
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 763 740 $9K
92557 131 131 $9K
92552 805 802 $9K
99152 205 196 $9K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 525 525 $9K
99281 Emergency department visit for the evaluation and management, self-limited or minor 397 393 $9K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 1,729 1,660 $9K
90834 Psychotherapy, 45 minutes with patient 123 109 $8K
90680 940 939 $8K
90677 666 665 $8K
94010 214 213 $8K
95909 39 38 $8K
29405 56 41 $8K
99441 1,765 1,740 $8K
99443 1,261 1,233 $7K
80061 Lipid panel 646 644 $7K
64615 55 55 $7K
94060 317 316 $7K
G9008 Coordinated care fee, physician coordinated care oversight services 14,012 6,113 $7K
73564 243 241 $7K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 46 46 $7K
81025 9,174 8,988 $7K
64405 82 72 $7K
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf 140 139 $6K
96127 2,087 2,047 $6K
77014 150 27 $6K
77065 Tomosynthesis, mammo 52 52 $6K
51798 94 90 $6K
99253 124 123 $6K
83036 Hemoglobin; glycosylated (A1C) 734 718 $6K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,997 1,818 $6K
77063 Screening digital breast tomosynthesis, bilateral 113 113 $6K
25600 24 24 $6K
93294 347 346 $6K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 421 412 $6K
97750 158 158 $5K
95115 642 295 $5K
99384 109 104 $5K
77080 180 180 $5K
90656 765 765 $5K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 110 110 $5K
99382 82 81 $5K
90961 271 271 $5K
J0897 Injection, denosumab, 1 mg 15 15 $5K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 1,430 1,377 $5K
99242 57 57 $5K
94727 145 144 $4K
84439 570 553 $4K
99381 76 70 $4K
29065 28 26 $4K
90460 Immunization administration through 18 years of age via any route, first or only component 5,843 1,869 $4K
92504 163 152 $4K
88141 71 36 $4K
99220 67 64 $3K
69210 130 123 $3K
62323 13 13 $3K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 114 78 $3K
J1580 Injection, garamycin, gentamicin, up to 80 mg 644 591 $3K
99306 Prolong nursin fac eval 15m 182 172 $3K
99451 80 79 $3K
Z1032 24 24 $3K
82962 2,314 2,194 $3K
94375 63 62 $3K
93245 25 25 $3K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,659 1,560 $3K
76770 26 26 $3K
99356 66 29 $3K
77334 32 31 $2K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 581 559 $2K
93248 99 98 $2K
99218 81 80 $2K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 59 59 $2K
73080 87 71 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,295 1,295 $2K
99386 39 39 $2K
94726 157 157 $2K
93880 13 13 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg 2,624 2,562 $2K
99406 221 169 $2K
92550 58 58 $2K
90685 196 195 $2K
95251 67 67 $2K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 30 30 $2K
90832 Psychotherapy, 30 minutes with patient 26 25 $2K
31575 13 13 $2K
76536 27 27 $2K
97035 170 114 $1K
99072 302 286 $1K
93296 180 180 $1K
81003 5,049 5,012 $1K
99173 1,686 1,553 $1K
J2405 Injection, ondansetron hydrochloride, per 1 mg 165 155 $1K
99494 14 13 $1K
93308 33 24 $1K
31231 12 12 $1K
99217 55 53 $1K
99153 Mod sedat endo service >5yrs 30 28 $1K
77263 12 12 $1K
93295 28 28 $1K
72040 37 37 $992.48
95800 26 26 $992.00
73100 58 51 $986.10
G0008 Administration of influenza virus vaccine 677 676 $940.59
11721 210 208 $901.25
77300 17 14 $879.54
95717 13 12 $870.78
J1071 Injection, testosterone cypionate, 1 mg 208 133 $865.89
93280 100 96 $842.01
90688 136 136 $833.83
93246 57 56 $817.26
69209 294 291 $707.15
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 45 45 $606.67
0001A 15 15 $600.00
99172 31 31 $570.40
0002A 14 14 $560.00
90697 12 12 $529.17
0031A 13 13 $520.00
12001 28 28 $516.28
81001 195 189 $491.72
90480 12 12 $480.00
76937 29 24 $476.80
90662 285 285 $465.75
86580 109 107 $449.05
3074F 37,483 34,709 $437.50
96402 27 26 $417.42
J0696 Injection, ceftriaxone sodium, per 250 mg 702 687 $392.60
G9919 Screening performed and positive and provision of recommendations 13 13 $377.00
93356 49 49 $362.56
83735 62 49 $347.60
85610 672 577 $330.53
93290 12 12 $305.53
J3121 Injection, testosterone enanthate, 1 mg 34 26 $301.00
73560 29 26 $233.21
86308 599 598 $169.97
73590 17 15 $164.94
86140 35 32 $162.05
J1030 Injection, methylprednisolone acetate, 40 mg 14 14 $139.03
71045 Radiologic examination, chest; single view 12 12 $136.17
87086 Culture, bacterial; quantitative colony count, urine 19 19 $135.85
90713 15 15 $135.00
73140 12 12 $134.16
82951 13 13 $133.77
90619 29 29 $126.00
90714 13 13 $117.56
90649 13 13 $117.00
80048 Basic metabolic panel (calcium, ionized) 15 14 $109.05
1111F 111 111 $96.84
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 58 55 $95.30
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 17 17 $90.92
90694 77 77 $75.22
85652 25 25 $59.64
G0009 Administration of pneumococcal vaccine 74 74 $55.07
10060 13 13 $42.44
17000 13 13 $33.44
93325 13 13 $28.28
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 248 242 $27.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 12 12 $19.80
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) 16 13 $13.96
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 388 307 $11.66
36416 216 212 $8.37
36415 Collection of venous blood by venipuncture 225 210 $8.09
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) 12 12 $0.96
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen 33 33 $0.34
1036F 19,016 18,761 $0.00
3079F 17,373 16,788 $0.00
3080F 3,415 3,331 $0.00
3075F 6,936 6,805 $0.00
H0049 Alcohol and/or drug screening 3,499 3,485 $0.00
87276 16 16 $0.00
3354F 71 70 $0.00
A6449 Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard 118 116 $0.00
1220F 91 89 $0.00
3078F 29,853 27,779 $0.00
3077F 6,144 5,876 $0.00
90461 1,764 1,152 $0.00
3725F 164 160 $0.00
4004F 45 43 $0.00
96160 27 27 $0.00
99448 47 47 $0.00