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

99215E&M

Established patient office visit, high complexity

Total Paid

$2.77B

$2,771,835,859

Beneficiaries

25.3M

25,340,122

Avg $/Claim

$94

Median: $182

Utilization

1.2 claims/bene

29,996 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
1891849725

ALABAMA DEPARTMENT OF REHABILITATION SERVICES

AL$42.0M$1,871vs $182 med10.28x22,46921,250
2
1699703827

LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH

CA$39.8M$1,007vs $182 med5.54x39,52434,293
3
1346218294

BOSTON MEDICAL CENTER CORPORATION

MA$28.0M$147vs $182 med0.81x190,774173,688
4
1265813125

TOBIAS MOELLER-BERTRAM, MD CORPORATION DESERT CLINIC PAIN INSTITUTE

CA$21.2M$829vs $182 med4.56x25,57521,833
5
1952476988

MONTEFIORE MEDICAL CENTER

NY$17.0M$187vs $182 med1.03x91,03583,839
6
1962461889

UNIVERSITY PHYSICIANS INCORPORATED

CO$16.6M$110vs $182 med0.61x150,525137,566
7
1194934471

COUNTY OF SAN BERNARDINO

CA$13.9M$1,161vs $182 med6.38x11,97211,487
8
1457788275

IDEAL OPTION, PLLC

WA$12.6M$152vs $182 med0.83x83,25262,796
9
1528263910

COUNTY OF SANTA CLARA

CA$12.0M$1,351vs $182 med7.42x8,8797,545
10
1467454967

BOSTON CHILDREN'S HEALTH PHYSICIANS, LLP

NY$11.5M$198vs $182 med1.09x58,15652,175
11
1134152986

NATIONWIDE CHILDREN'S HOSPITAL

OH$11.3M$121vs $182 med0.67x93,23674,231
12
1548378235

MEDSTAR WASHINGTON HOSPITAL CENTER

DC$10.8M$194vs $182 med1.07x55,81648,444
13
1396886297

CHILDREN'S SPECIALIZED HOSPITAL

NJ$10.4M$294vs $182 med1.62x35,33734,339
14
1669617197

RADY CHILDREN'S HOSPITAL SAN DIEGO

CA$10.2M$126vs $182 med0.69x81,49173,141
15
1861506560

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON

OH$10.1M$164vs $182 med0.90x61,51754,598
16
1437555265

VALLEY CHILDREN'S MEDICAL GROUP

CA$10.1M$122vs $182 med0.67x82,70277,584
17
1043386659

COUNTY OF SACRAMENTO

CA$9.9M$985vs $182 med5.41x10,0659,555
18
1861675506

TEXAS CHILDREN'S PHYSICIAN GROUP

TX$9.5M$89vs $182 med0.49x106,06698,352
19
1326046467

THE BROOKLYN HOSPITAL CENTER

NY$9.2M$114vs $182 med0.62x81,30169,041
20
1407897309

HENNEPIN HEALTHCARE SYSTEM, INC

MN$9.2M$99vs $182 med0.54x92,87780,421
21
1477624104

UCSF MEDICAL GROUP BUSINESS SERVICES

CA$9.2M$127vs $182 med0.70x71,98066,133
22
1164512851

UNIVERSITY OF CALIFORNIA SAN FRANCISCO

CA$9.0M$125vs $182 med0.68x72,31663,901
23
1104802354

PRESBYTERIAN HEALTHCARE SERVICES

NM$8.8M$108vs $182 med0.59x81,45876,661
24
1053688572

NORTH SHORE-LIJ MEDICAL PC

NY$8.5M$158vs $182 med0.87x54,02551,727
25
1063525152

MONTEFIORE MEDICAL CENTER

NY$8.5M$131vs $182 med0.72x64,57060,356

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$571.7M$1065,415,7384,812,3034,240
2NY$247.1M$1401,766,3871,542,5762,046
3OH$131.3M$921,433,0261,217,9521,036
4MI$125.7M$931,346,1681,252,9591,162
5MA$112.9M$991,145,0461,034,807671
6MD$96.3M$119809,426636,0851,001
7AZ$90.6M$721,250,7871,087,205929
8NC$85.7M$841,014,462791,0481,132
9CO$80.4M$104773,476608,212742
10MN$78.9M$93846,651723,875423
11TX$78.3M$711,100,146989,2791,012
12NJ$74.9M$97774,702638,027738
13FL$74.8M$92815,441673,405973
14WA$69.0M$93740,427649,231538
15AL$65.9M$240274,636230,476335
16VA$62.9M$93675,021561,331601
17PA$54.5M$88620,917546,0131,216
18LA$54.2M$57945,815792,081706
19IN$47.8M$90531,481424,867509
20NM$46.6M$109428,097383,219319
21OR$39.7M$107370,754309,721530
22CT$37.8M$73519,954396,876380
23TN$35.3M$58604,263468,159663
24DC$34.8M$122285,923234,424122
25WI$33.5M$58573,493487,656349

57 rows · Page 1 of 3