Medicaid Provider Spending

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

PROHEALTH PRIMARY CARE LLC

NPI: 1982962692 · ABERDEEN, MD 21001 · Family Medicine Physician · NPI assigned 05/01/2012

$5.42M
Total Medicaid Paid
100,416
Total Claims
87,640
Beneficiaries
53
Codes Billed
2019-10
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSUMILANG, NATHANIEL (PHYSICIAN/OWNER)
NPI Enumeration Date05/01/2012

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 14 $748.30
2020 21,125 $1.05M
2021 17,940 $959K
2022 20,746 $1.13M
2023 21,800 $1.20M
2024 18,791 $1.08M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 26,527 21,987 $2.16M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 10,813 9,545 $1.26M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3,312 3,137 $345K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 3,017 2,783 $306K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 3,192 2,752 $299K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,093 1,926 $235K
99401 4,956 4,299 $157K
96127 7,343 6,754 $61K
90686 2,336 2,100 $48K
90648 2,150 2,032 $47K
96110 Developmental screening, with scoring and documentation, per standardized instrument 3,986 3,759 $42K
90670 1,792 1,708 $40K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 3,289 1,586 $38K
90677 388 355 $33K
90723 1,496 1,404 $33K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials 35 13 $31K
92551 2,742 2,546 $25K
90633 1,054 1,008 $23K
90680 943 890 $20K
90707 909 878 $20K
90716 889 861 $20K
90651 761 721 $18K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 483 449 $17K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 155 129 $17K
90700 710 654 $15K
99381 169 151 $14K
90734 565 533 $13K
90688 513 484 $11K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 37 37 $10K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 739 677 $9K
96161 3,594 2,915 $9K
99173 2,638 2,438 $6K
96160 2,143 1,933 $5K
G0444 Annual depression screening, 5 to 15 minutes 478 459 $5K
90715 244 215 $5K
90656 226 221 $5K
99050 355 329 $4K
90381 18 17 $3K
90713 141 138 $3K
92567 190 161 $3K
G0396 Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes 167 157 $2K
G0442 Annual alcohol misuse screening, 5 to 15 minutes 139 134 $2K
90619 38 26 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 13 13 $1K
90621 25 25 $811.39
90696 32 28 $651.84
94760 426 342 $566.60
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 208 185 $552.57
87807 40 36 $435.90
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 29 27 $372.65
84030 29 28 $90.74
99000 1,820 1,628 $59.72
36416 29 27 $0.00