Medicaid Provider Spending

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

PROSPECT HEALTH ACCESS NETWORK, INC.

NPI: 1912354432 · CHESTER, PA 19013 · Rheumatology Physician · NPI assigned 05/16/2016

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

Authorized official ELDERS, ROBERT controls 20+ related entities in our dataset. Read more

$651K
Total Medicaid Paid
37,243
Total Claims
35,264
Beneficiaries
33
Codes Billed
2018-04
First Month
2024-11
Last Month

Provider Details

Authorized OfficialELDERS, ROBERT (SECRETARY)
NPI Enumeration Date05/16/2016

Related Entities

Other providers sharing the same authorized official: ELDERS, ROBERT

ProviderCityStateTotal Paid
PROSPECT WATERBURY, INC. WATERBURY CT $84.62M
PROSPECT MANCHESTER HOSPITAL, INC. MANCHESTER CT $69.20M
PROSPECT CHARTERCARE RWMC, LLC PROVIDENCE RI $57.10M
PROSPECT CCMC, LLC CHESTER PA $40.89M
PROSPECT CT MEDICAL FOUNDATION, INC. MANCHESTER CT $34.07M
PROSPECT ROCKVILLE HOSPITAL, INC. VERNON CT $30.06M
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $10.94M
PROSPECT DCMH, LLC DREXEL HILL PA $10.37M
PROSPECT CCMC, LLC CHESTER PA $5.46M
ALTA LOS ANGELES HOSPITALS, INC. LOS ANGELES CA $5.42M
PROSPECT CCMC, LLC CHESTER PA $5.03M
PROSPECT CCMC, LLC CHESTER PA $3.71M
PROSPECT CHARTERCARE PHYSICIANS, LLC CRANSTON RI $2.31M
PROSPECT ECHN HOME HEALTH, INC. VERNON CT $1.75M
PROSPECT WATERBURY HOME HEALTH, INC. WATERTOWN CT $1.30M
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $1.22M
ALTA NEWPORT HOSPITAL, LLC TUSTIN CA $1.16M
PROSPECT HEALTH ACCESS NETWORK, INC. CRUM LYNNE PA $924K
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $872K
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $858K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 350 $7K
2019 20 $0.00
2020 2,104 $43K
2021 8,679 $157K
2022 8,884 $152K
2023 9,180 $152K
2024 8,026 $139K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 18,432 17,589 $374K
99309 Subsequent nursing facility care, per day, low to moderate complexity 4,874 4,210 $108K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 7,038 6,807 $97K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 258 254 $17K
90686 1,481 1,471 $14K
99215 Prolong outpt/office vis 621 610 $12K
99308 Subsequent nursing facility care, per day, straightforward 373 331 $9K
99349 218 204 $3K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 172 171 $2K
90715 63 62 $2K
90656 198 198 $2K
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 570 535 $1K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 101 101 $1K
99222 Initial hospital care, per day, moderate complexity 17 12 $1K
90732 27 27 $972.33
3074F 648 638 $943.71
3079F 566 564 $773.92
90662 85 85 $666.10
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 67 65 $643.48
99385 15 15 $595.81
99318 17 16 $526.53
99232 Subsequent hospital care, per day, moderate complexity 22 12 $366.19
99238 Hospital discharge day management, 30 minutes or less 27 26 $356.25
3078F 201 195 $350.98
36415 Collection of venous blood by venipuncture 312 306 $302.13
86580 285 248 $261.64
82962 350 337 $253.51
3077F 78 78 $80.56
3725F 46 16 $30.40
3075F 36 36 $30.26
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 12 12 $13.86
3080F 13 13 $0.10
90653 20 20 $0.00