Medicaid Provider Spending

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

1902035140

NPI: 1902035140

Deactivated NPI · This NPI was deactivated on 07/30/2024.
$20K
Total Medicaid Paid
1,167
Total Claims
1,122
Beneficiaries
9
Codes Billed
2018-01
First Month
2023-01
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 124 $2K
2019 56 $204.40
2020 126 $2K
2021 518 $11K
2022 328 $6K
2023 15 $188.40

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 557 524 $6K
0064A 147 147 $5K
90686 249 241 $4K
0012A 48 48 $2K
90674 62 60 $1K
0011A 30 30 $1K
0134A 28 28 $1K
S9430 Pharmacy compounding and dispensing services 33 31 $0.00
90620 13 13 $0.00