Providence Health Alliance
Providence Health Alliance was paid $4.79M by Medicaid between Jan 2018 and Dec 2024, across 118 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.
33Billing provider infoPROVIDENCE HEALTH ALLIANCE
WACO, TX 76712
WACO, TX 76712
33aNPI1932210838assigned 08/31/2006
33bProvider typeSpecialist
28Total paid$4.79M
24GClaims246,933
24DCodes billed118
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in Texas
Rank by total paid#6 of 382
Median peer was paid$29K
This provider vs. median165×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,042 | $4K | |
| 2019 | 912 | $3K | |
| 2020 | 7,606 | $130K | |
| 2021 | 65,567 | $1.18M | |
| 2022 | 76,318 | $1.47M | |
| 2023 | 62,626 | $1.31M | |
| 2024incomplete | 32,862 | $694K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 37% | 58,825 | 48,409 | $1.76M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 17% | 19,327 | 17,642 | $815K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.4% | 4,516 | 4,459 | $354K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.4% | 4,377 | 3,952 | $306K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 6.0% | 3,769 | 3,374 | $285K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.7% | 2,194 | 2,130 | $177K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 2.7% | 1,363 | 1,290 | $130K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.5% | 13,500 | 5,650 | $118K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.8% | 1,203 | 1,125 | $88K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.8% | 7,399 | 6,833 | $85K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.3% | 5,073 | 4,963 | $62K |
| 99243 | 1.2% | 776 | 682 | $56K |
106 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.1% | 4,607 | $54K |
| 81002 | <1% | 17,427 | $43K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 5,085 | $42K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 518 | $41K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,879 | $35K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 811 | $31K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 748 | $31K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 316 | $30K |
| 90461 | <1% | 3,989 | $25K | |
| 87428 | <1% | 815 | $24K | |
| 27096 | <1% | 188 | $17K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 2,812 | $16K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 311 | $16K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,403 | $11K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 2,029 | $11K |
| 81025 | <1% | 2,039 | $11K | |
| 92567 | <1% | 1,270 | $10K | |
| 80305 | <1% | 1,709 | $8K | |
| 99000 | <1% | 1,013 | $8K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 235 | $8K |
| 90474 | <1% | 942 | $8K | |
| 59430 | <1% | 85 | $7K | |
| 92557 | <1% | 344 | $7K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 87 | $5K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 53 | $4K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 1,065 | $4K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 329 | $3K |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | <1% | 13 | $3K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 40 | $3K |
| 92555 | <1% | 212 | $2K | |
| 73100 | <1% | 80 | $2K | |
| 0001A | <1% | 211 | $2K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 36 | $2K |
| 0002A | <1% | 144 | $2K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 354 | $2K |
| 0071A | <1% | 37 | $2K | |
| 99334 | <1% | 41 | $1K | |
| 76942 | <1% | 44 | $1K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 35 | $1K |
| 20553 | <1% | 50 | $1K | |
| 0072A | <1% | 28 | $1K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 61 | $1K |
| 90715 | <1% | 85 | $1K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 68 | $1K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 15 | $874.80 |
| 87807 | <1% | 86 | $856.79 | |
| 90686 | <1% | 1,708 | $842.37 | |
| 95811 | <1% | 12 | $827.57 | |
| 95251 | <1% | 104 | $792.16 | |
| 73630 | <1% | 33 | $675.77 | |
| 51798 | <1% | 153 | $557.17 | |
| 99221 | <1% | 12 | $554.68 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 408 | $389.29 |
| 81003 | <1% | 265 | $293.10 | |
| 0003A | <1% | 21 | $292.00 | |
| 90677 | <1% | 476 | $285.55 | |
| 81001 | <1% | 121 | $274.32 | |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 49 | $196.25 |
| 99443 | <1% | 12 | $164.42 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12 | $66.11 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 44 | $61.46 |
| 99310 | Prolong nursin fac eval 15m | <1% | 14 | $52.70 |
| 92551 | <1% | 531 | $4.59 | |
| 91300 | <1% | 168 | $0.20 | |
| 90697 | <1% | 73 | $0.18 | |
| 91307 | <1% | 105 | $0.13 | |
| 1036F | <1% | 10,473 | $0.13 | |
| 1126F | <1% | 2,027 | $0.10 | |
| 1160F | 0% | 10,070 | $0.00 | |
| 90670 | 0% | 2,728 | $0.00 | |
| 90648 | 0% | 995 | $0.00 | |
| 90685 | 0% | 445 | $0.00 | |
| 3078F | 0% | 7,801 | $0.00 | |
| 90633 | 0% | 1,017 | $0.00 | |
| 90710 | 0% | 184 | $0.00 | |
| 90707 | 0% | 64 | $0.00 | |
| 3725F | 0% | 422 | $0.00 | |
| 3077F | 0% | 198 | $0.00 | |
| 99173 | 0% | 396 | $0.00 | |
| 1159F | 0% | 171 | $0.00 | |
| 90700 | 0% | 55 | $0.00 | |
| 90734 | 0% | 21 | $0.00 | |
| 99453 | 0% | 27 | $0.00 | |
| 99306 | Prolong nursin fac eval 15m | 0% | 12 | $0.00 |
| 3074F | 0% | 8,576 | $0.00 | |
| 3008F | 0% | 10,523 | $0.00 | |
| 90723 | 0% | 508 | $0.00 | |
| 3079F | 0% | 752 | $0.00 | |
| 1125F | 0% | 4,237 | $0.00 | |
| 90651 | 0% | 89 | $0.00 | |
| 90698 | 0% | 872 | $0.00 | |
| 90656 | 0% | 274 | $0.00 | |
| 3075F | 0% | 134 | $0.00 | |
| 82962 | 0% | 539 | $0.00 | |
| 90744 | 0% | 257 | $0.00 | |
| 90680 | 0% | 1,261 | $0.00 | |
| 36416 | 0% | 536 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 393 | $0.00 |
| 90696 | 0% | 76 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 54 | $0.00 |
| 90716 | 0% | 63 | $0.00 | |
| 90619 | 0% | 35 | $0.00 | |
| 99024 | 0% | 130 | $0.00 | |
| 96127 | 0% | 95 | $0.00 | |
| 99454 | 0% | 12 | $0.00 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 0% | 19 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCARSNER, CLAYTON (VP/COO)
| Provider | Location | Paid |
|---|---|---|
| Dell Children's Medical Group | Austin, TX | $11.07M |
| Seton Family of Doctors | Austin, TX | $4.00M |
| Dell Children's Medical Group | Round Rock, TX | $2.24M |
| Seton Family of Doctors | Kyle, TX | $1.93M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.