Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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THE INSTITUTE FOR FAMILY HEALTH

NPI: 1972877017 · NEW YORK, NY 10035 · Clinical Social Worker · NPI assigned 03/07/2012

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

Authorized official GAYLE, ERIC controls 19+ related entities in our dataset. Read more

$80.80M
Total Medicaid Paid
1,436,129
Total Claims
1,203,845
Beneficiaries
155
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGAYLE, ERIC (PRESIDENT AND CEO)
Parent OrganizationTHE INSTITUTE FOR FAMILY HEALTH
NPI Enumeration Date03/07/2012

Related Entities

Other providers sharing the same authorized official: GAYLE, ERIC

ProviderCityStateTotal Paid
THE INSTITUTE FOR FAMILY HEALTH NEW PALTZ NY $15.21M
THE INSTITUTE FOR FAMILY HEALTH NEW YORK NY $6.27M
THE INSTITUTE FOR FAMILY HEALTH BRONX NY $4.99M
THE INSTITUTE FOR FAMILY HEALTH BRONX NY $4.85M
THE INSTITUTE FOR FAMILY HEALTH KINGSTON NY $4.47M
THE INSTITUTE FOR FAMILY HEALTH ELLENVILLE NY $1.98M
THE INSTITUTE FOR FAMILY HEALTH NEW YORK NY $1.35M
THE INSTITUTE FOR FAMILY HEALTH NEW PALTZ NY $1.33M
THE INSTITUTE FOR FAMILY HEALTH BROOKLYN NY $1.26M
THE INSTITUTE FOR FAMILY HEALTH BRONX NY $1.00M
THE INSTITUTE FOR FAMILY HEALTH BRONX NY $964K
THE INSTITUTE FOR FAMILY HEALTH BRONX NY $927K
THE INSTITUTE FOR FAMILY HEALTH HYDE PARK NY $659K
THE INSTITUTE FOR FAMILY HEALTH NEW YORK NY $576K
THE INSTITUTE FOR FAMILY HEALTH KINGSTON NY $478K
THE INSTITUTE FOR FAMILY HEALTH NEW YORK NY $139K
THE INSTITUTE FOR FAMILY HEALTH BRONX NY $111K
THE INSTITUTE FOR FAMILY HEALTH NEW YORK NY $16K
THE INSTITUTE FOR FAMILY HEALTH NEW YORK NY $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 158,346 $9.57M
2019 181,714 $9.43M
2020 205,239 $10.89M
2021 246,283 $13.40M
2022 245,498 $14.25M
2023 239,660 $13.71M
2024 159,389 $9.56M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 295,735 276,143 $20.95M
90832 Psychotherapy, 30 minutes with patient 122,071 77,080 $17.60M
90834 Psychotherapy, 45 minutes with patient 85,090 49,625 $12.97M
99499 89,812 74,802 $10.54M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 57,946 55,556 $3.91M
D7999 110,778 24,399 $2.92M
90791 Psychiatric diagnostic evaluation 12,587 12,089 $2.09M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 25,643 24,593 $1.55M
D1110 Prophylaxis - adult 19,874 19,782 $679K
90792 Psychiatric diagnostic evaluation with medical services 3,317 3,294 $603K
D0120 Periodic oral evaluation - established patient 22,258 21,623 $470K
D1120 Prophylaxis - child 12,355 12,354 $399K
D0274 Bitewings - four radiographic images 18,504 18,479 $342K
99442 4,817 4,475 $288K
D0220 Intraoral - periapical first radiographic image 30,692 30,518 $274K
90460 Immunization administration through 18 years of age via any route, first or only component 14,268 14,188 $270K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 29,860 29,463 $235K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2,374 2,374 $211K
90839 1,236 1,175 $198K
90674 12,195 12,161 $196K
G9005 Coordinated care fee, risk adjusted maintenance 593 591 $194K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 2,152 2,147 $188K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 3,112 2,875 $176K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1,861 1,858 $169K
D0150 Comprehensive oral evaluation - new or established patient 8,038 7,888 $161K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,839 1,732 $155K
99215 Prolong outpt/office vis 1,060 1,018 $151K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 2,858 2,644 $144K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 1,698 1,696 $142K
D1351 Sealant - per tooth 2,592 1,731 $132K
D0230 Intraoral - periapical each additional radiographic image 18,759 18,707 $115K
D1208 Topical application of fluoride, excluding varnish 10,018 10,017 $115K
D2391 Resin-based composite - one surface, posterior, primary or permanent 3,159 2,763 $107K
99441 2,341 2,037 $102K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 1,084 1,076 $100K
99232 Subsequent hospital care, per day, moderate complexity 2,237 884 $92K
D0140 Limited oral evaluation - problem focused 8,298 8,151 $89K
3074F 85,238 79,623 $82K
D1206 Topical application of fluoride varnish 2,988 2,984 $74K
D0272 Bitewings - two radiographic images 5,484 5,484 $69K
90677 411 411 $67K
0012A 2,056 2,056 $67K
91322 574 568 $60K
0064A 1,609 1,600 $60K
83036 Hemoglobin; glycosylated (A1C) 10,148 9,876 $57K
36415 Collection of venous blood by venipuncture 41,150 39,974 $54K
0011A 2,082 2,077 $52K
59426 1,179 839 $52K
90461 2,585 2,581 $48K
D0330 Panoramic radiographic image 2,581 2,578 $47K
D0210 Intraoral - complete series of radiographic images 6,260 6,248 $47K
G0470 Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit 478 144 $46K
90853 Group psychotherapy (other than of a multiple-family group) 1,089 584 $44K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 493 493 $44K
90715 1,187 1,185 $43K
82947 17,155 15,912 $40K
T2022 Case management, per month 117 108 $37K
J1050 Injection, medroxyprogesterone acetate, 1 mg 583 583 $35K
D7140 Extraction, erupted tooth or exposed root 930 753 $35K
99385 336 336 $33K
0134A 976 907 $30K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 3,083 2,934 $28K
3078F 68,065 64,004 $28K
D4341 788 510 $27K
90756 1,632 1,626 $26K
D0270 2,695 2,685 $24K
99239 Hospital discharge day management, more than 30 minutes 387 368 $24K
98960 757 695 $23K
90661 1,083 1,083 $22K
92551 5,375 5,366 $19K
99201 96 96 $19K
81025 3,828 3,723 $19K
90480 560 556 $18K
90732 200 200 $16K
99000 32,039 31,051 $16K
86703 1,928 1,921 $15K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 1,591 1,506 $15K
D9110 984 968 $14K
93000 1,034 1,011 $13K
90472 Immunization administration, each additional vaccine (list separately) 1,117 1,109 $13K
99443 276 256 $11K
80305 2,965 2,833 $11K
86701 1,671 1,664 $10K
85018 5,289 5,255 $8K
3079F 19,275 18,269 $7K
90651 130 130 $7K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 51 51 $7K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 84 42 $6K
D9310 115 115 $5K
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 224 89 $5K
99238 Hospital discharge day management, 30 minutes or less 90 86 $4K
99233 Prolong inpt eval add15 m 84 40 $4K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 441 434 $4K
0071A 92 88 $4K
D0240 480 434 $4K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 62 62 $4K
99173 5,366 5,355 $4K
90686 1,845 1,826 $4K
97802 85 85 $4K
99205 Prolong outpt/office vis 16 16 $4K
1170F 8,453 6,480 $3K
99222 Initial hospital care, per day, moderate complexity 77 75 $3K
99383 33 33 $3K
99406 212 211 $3K
97803 55 55 $3K
D2930 Prefabricated stainless steel crown - primary tooth 31 25 $3K
3077F 3,196 2,886 $3K
99460 26 26 $2K
90746 40 40 $2K
81002 1,039 1,010 $2K
99386 16 16 $2K
0031A 60 60 $2K
G9001 Coordinated care fee, initial rate 26 26 $2K
3075F 5,261 5,010 $2K
99384 13 13 $2K
D1354 105 44 $1K
99223 Prolong inpt eval add15 m 14 14 $1K
0072A 29 29 $1K
11721 54 54 $1K
99462 14 13 $1K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 14 14 $990.00
3008F 5,113 5,025 $915.42
90694 62 62 $844.56
90734 116 116 $720.00
D4342 35 32 $648.97
83655 165 165 $515.71
D1330 6,320 6,313 $407.16
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 187 185 $390.00
86580 41 40 $292.37
D0145 Oral evaluation for a patient under three years of age 12 12 $287.50
0502F 1,266 833 $276.31
D0160 12 12 $235.75
90670 237 237 $230.83
90653 13 13 $187.40
Q0144 Azithromycin dihydrate, oral, capsules/powder, 1 gram 13 13 $144.30
D4921 175 101 $114.24
1159F 1,306 906 $97.75
3080F 1,851 1,669 $55.00
T1016 Case management, each 15 minutes 38 37 $22.50
3044F 1,056 1,035 $20.00
J1885 Injection, ketorolac tromethamine, per 15 mg 29 28 $5.19
3051F 390 382 $0.02
90744 24 24 $0.00
1126F 161 106 $0.00
3052F 177 174 $0.00
91301 328 325 $0.00
90698 78 78 $0.00
90656 58 58 $0.00
91306 166 166 $0.00
3046F 708 655 $0.00
1160F 425 363 $0.00
97813 17 13 $0.00
A4550 Surgical trays 24 24 $0.00
90633 57 57 $0.00
91313 18 18 $0.00