Medicaid Provider Spending Explorer

T-MSIS provider-level spending data, Jan 2018 – Dec 2024

Data note: November and December 2024 data may be incomplete due to CMS reporting delays (typically 3–6 months for full coverage). Learn more
← All Procedures

99204E&M

New patient office visit, moderate complexity

Total Paid

$2.98B

$2,979,909,396

Beneficiaries

30.2M

30,167,906

Avg $/Claim

$92

Median: $118

Utilization

1.1 claims/bene

42,686 providers

Monthly Spending

Total payments per month (nominal $)

Cost per Claim

Average cost per claim per month (nominal $)

Beneficiaries

Unique beneficiaries per month

Top Providers for This Procedure

Each dot is a provider. X = cost index (vs procedure median). Y = total spending.

Drag to zoom into a region

Provider Rankings

#ProviderStateTotal Paid$/ClaimCost IndexClaimsBeneficiaries
1
1730491945

CITY MEDICAL OF UPPER EAST SIDE, PLLC

NY$29.1M$111vs $118 med0.94x262,867262,217
2
1134452865

FAST PACE MEDICAL CLINIC PLLC

TN$16.8M$73vs $118 med0.62x230,143194,573
3
1063525152

MONTEFIORE MEDICAL CENTER

NY$15.8M$151vs $118 med1.28x104,761104,012
4
1053688572

NORTH SHORE-LIJ MEDICAL PC

NY$15.3M$173vs $118 med1.47x88,04887,932
5
1043371826

NEXTCARE ARIZONA LLC

AZ$14.6M$103vs $118 med0.87x141,986138,324
6
1457478703

MNR INDUSTRIES, LLC

MD$10.4M$118vs $118 med1.00x88,45782,155
7
1346218294

BOSTON MEDICAL CENTER CORPORATION

MA$10.0M$121vs $118 med1.03x82,69379,986
8
1104202761

VANDERBILT UNIVERSITY MEDICAL CENTER

TN$9.2M$132vs $118 med1.12x69,32659,885
9
1013374222

LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE

LA$9.0M$125vs $118 med1.06x72,03265,541
10
1285826438

NEW YORK UNIVERSITY

FL$8.5M$161vs $118 med1.37x52,77551,506
11
1912976408

PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES, INC.

CA$8.5M$252vs $118 med2.14x33,78233,610
12
1275504508

WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION

WV$8.4M$92vs $118 med0.78x91,94682,703
13
1134349954

BOBBY BUKA, M.D., P.C.

NY$8.3M$172vs $118 med1.46x48,04548,012
14
1467536276

SEATTLE CHILDREN'S HOSPITAL

WA$8.1M$131vs $118 med1.11x62,20260,936
15
1942623319

MEDSTAR URGENT CARE LLC

MD$7.9M$109vs $118 med0.93x72,10162,746
16
1225331903

FASTMED URGENT CARE PC

NC$7.7M$104vs $118 med0.88x74,34163,211
17
1932586476

RURAL URGENT CARE LLC

AL$6.8M$66vs $118 med0.56x104,23685,486
18
1467715490

CALCASIEU URGENT CARE LLC

LA$6.7M$75vs $118 med0.64x89,41279,711
19
1962461889

UNIVERSITY PHYSICIANS INCORPORATED

CO$6.7M$136vs $118 med1.16x48,96547,271
20
1619368842

COMMUNITY CARE HEALTH NETWORK LLC

TN$6.6M$109vs $118 med0.93x60,41625,832
21
1073827101

VHS PHYSICIANS OF MICHIGAN

MI$6.6M$83vs $118 med0.71x79,18778,311
22
1730479254

URGENT CARE MEDICAL ASSOCIATES, LLC

CT$6.3M$114vs $118 med0.96x55,84049,832
23
1235188673

SPECTRUM HEALTH PRIMARY CARE PARTNERS

MI$6.2M$85vs $118 med0.72x73,16971,680
24
1578665048

OPTUM MEDICAL CARE OF NEW JERSEY PC

NJ$6.1M$128vs $118 med1.09x47,66745,935
25
1790185577

DUKE CITY URGENT CARE

NM$6.0M$132vs $118 med1.12x45,50944,701

50 rows · Page 1 of 2

State Breakdown

Each dot is a state. X = average cost per claim. Y = total spending.

Drag to zoom into a region

State Rankings

#StateTotal PaidAvg $/ClaimClaimsBeneficiariesProviders
1CA$429.0M$745,776,3045,655,1335,881
2NY$375.5M$1302,881,6722,842,8903,831
3MI$180.5M$862,109,6832,089,5901,867
4FL$131.8M$1101,195,0631,029,3721,850
5LA$121.3M$781,555,8061,382,4211,175
6AZ$111.9M$861,300,6241,249,2261,161
7NJ$99.9M$109917,241873,8541,166
8TN$97.8M$801,221,1191,011,3101,081
9OH$92.8M$721,296,2761,207,6221,411
10VA$84.4M$102826,198769,888968
11MD$84.3M$103818,981724,295933
12IN$78.8M$92857,416747,441791
13NC$78.4M$93841,604672,6551,313
14TX$75.9M$80944,108903,0001,520
15MA$71.8M$104691,325677,213878
16OK$68.6M$150455,611454,745727
17KY$63.5M$72884,658787,7761,029
18CO$58.6M$117502,324448,8491,016
19NM$49.9M$130383,248373,946376
20IL$49.9M$76654,677588,1392,830
21CT$48.1M$92520,579452,929478
22WA$46.1M$95486,904471,452526
23PA$42.9M$95452,682442,0221,416
24MN$38.4M$91419,832397,390346
25OR$36.4M$118307,723285,787534

57 rows · Page 1 of 3