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

99213E&M

Established patient office visit, low complexity

Total Paid

$33.00B

$33,002,827,264

Beneficiaries

639.4M

639,378,224

Avg $/Claim

$43

Median: $120

Utilization

1.2 claims/bene

164,075 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.

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Provider Rankings

#ProviderStateTotal Paid$/ClaimCost IndexClaimsBeneficiaries
1
1730491945

CITY MEDICAL OF UPPER EAST SIDE, PLLC

NY$226.5M$110vs $120 med0.92x2,049,9771,892,947
2
1134152986

NATIONWIDE CHILDREN'S HOSPITAL

OH$154.8M$85vs $120 med0.71x1,821,2141,274,644
3
1861506560

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON

OH$147.0M$148vs $120 med1.24x991,232879,763
4
1619969458

SUN RIVER HEALTH INC.

NY$140.9M$106vs $120 med0.89x1,331,305862,238
5
1184729493

WINSLOW INDIAN HEALTH CARE CENTER, INC

AZ$120.8M$532vs $120 med4.45x227,182158,733
6
1538378625

SOUTHCENTRAL FOUNDATION

AK$99.6M$687vs $120 med5.75x144,968134,243
7
1952476988

MONTEFIORE MEDICAL CENTER

NY$91.4M$159vs $120 med1.33x574,884509,794
8
1194832477

THE NEW YORK AND PRESBYTERIAN HOSPITAL

NY$65.1M$190vs $120 med1.59x343,159289,761
9
1417027558

BRONXCARE HEALTH SYSTEM

NY$64.7M$123vs $120 med1.03x526,832431,905
10
1548212988

CHILDREN'S HOSPITAL MEDICAL CENTER

OH$61.8M$108vs $120 med0.90x573,206521,812
11
1063525152

MONTEFIORE MEDICAL CENTER

NY$60.3M$76vs $120 med0.64x788,434748,014
12
1063436624

CARECONNECT HEALTH, INC.

GA$59.4M$109vs $120 med0.92x543,246458,249
13
1346218294

BOSTON MEDICAL CENTER CORPORATION

MA$57.4M$130vs $120 med1.09x440,043390,235
14
1548226988

UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON

TX$56.0M$79vs $120 med0.66x708,485605,423
15
1578665048

OPTUM MEDICAL CARE OF NEW JERSEY PC

NJ$54.1M$59vs $120 med0.49x919,464836,730
16
1255451597

MEDICAL ASSOCIATES OF EBNHC

MA$52.9M$103vs $120 med0.86x516,080438,236
17
1447477815

YUKON-KUSKOKWIM HEALTH CORPORATION

AK$51.2M$266vs $120 med2.23x192,348165,468
18
1811062763

MID ATLANTIC PEMANENTE MEDICAL GROUP

MD$50.8M$88vs $120 med0.74x575,655548,993
19
1780630608

RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA

VA$50.7M$205vs $120 med1.72x246,914206,988
20
1821201278

TANANA CHIEFS CONFERENCE

AK$50.0M$558vs $120 med4.67x89,62379,604
21
1609129402

PREMIUM HEALTH, INC.

NY$49.0M$149vs $120 med1.25x328,540187,393
22
1679970891

NORTH SHORE LIJ, URGENT CARE, P.C.

NY$48.9M$195vs $120 med1.63x251,247236,420
23
1548266547

BALTIMORE MEDICAL SYSTEM INC

MD$47.8M$214vs $120 med1.79x223,371191,594
24
1487603585

CAMBRIDGE PUBLIC HEALTH COMMISSION

MA$47.7M$96vs $120 med0.81x495,297421,088
25
1639138480

SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON

FL$46.4M$27vs $120 med0.22x1,735,5881,656,290

50 rows · Page 1 of 2

State Breakdown

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

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State Rankings

#StateTotal PaidAvg $/ClaimClaimsBeneficiariesProviders
1NY$6.09B$7383,858,90069,537,20819,181
2CA$1.79B$14123,998,897100,099,47414,540
3OH$1.65B$4338,182,31030,507,8905,099
4TX$1.41B$3936,069,19130,682,4546,038
5MI$1.18B$4824,843,22422,391,2194,764
6NJ$1.08B$4523,747,04720,579,1634,459
7FL$1.00B$4223,908,60219,769,4575,905
8KY$990.8M$3230,822,75524,765,9153,363
9MD$967.8M$7712,519,75010,464,1833,286
10NC$909.4M$4719,409,70915,635,1274,130
11IN$896.5M$4818,815,58515,281,3232,376
12CO$888.3M$969,301,9037,779,3032,550
13MA$873.2M$5615,522,93214,052,6505,317
14VA$801.3M$5514,639,06712,590,5624,011
15TN$745.0M$3521,303,11217,465,0044,054
16AZ$740.9M$4616,065,20613,879,2202,769
17SC$703.8M$6510,842,4449,681,9072,766
18LA$663.9M$2626,017,95520,805,2043,233
19MN$660.5M$689,678,6358,447,5551,197
20IL$556.0M$2323,866,05019,095,08814,300
21WA$550.7M$4312,662,07311,639,6031,866
22MS$532.3M$569,481,6257,776,7071,913
23AK$506.9M$2621,932,7101,610,282485
24PA$498.0M$3813,218,77712,123,1798,902
25NM$486.8M$845,812,1155,281,386935

63 rows · Page 1 of 3