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
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99393E&M

Preventive visit, established patient, age 5-11

Total Paid

$1.99B

$1,987,400,170

Beneficiaries

29.0M

29,004,311

Avg $/Claim

$63

Median: $101

Utilization

1.1 claims/bene

21,659 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
1639138480

SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON

FL$20.9M$57vs $101 med0.56x368,346361,473
2
1134152986

NATIONWIDE CHILDREN'S HOSPITAL

OH$17.4M$75vs $101 med0.74x231,890164,240
3
1861506560

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON

OH$16.6M$137vs $101 med1.35x121,188112,823
4
1285016758

TOPCARE MEDICAL GROUP INC

TX$15.3M$65vs $101 med0.64x235,403231,955
5
1700828852

THE METROHEALTH SYSTEM

OH$5.9M$115vs $101 med1.14x51,52947,683
6
1790839405

WELL CHILD INC.

TN$5.5M$78vs $101 med0.77x71,11662,015
7
1548212988

CHILDREN'S HOSPITAL MEDICAL CENTER

OH$5.4M$118vs $101 med1.16x45,66743,800
8
1063525152

MONTEFIORE MEDICAL CENTER

NY$5.4M$86vs $101 med0.85x62,16961,725
9
1750369203

COOK CHILDREN'S PHYSICIAN NETWORK

TX$5.0M$88vs $101 med0.87x57,31956,806
10
1578665048

OPTUM MEDICAL CARE OF NEW JERSEY PC

NJ$4.9M$97vs $101 med0.96x51,11050,429
11
1366594699

THE NEMOURS FOUNDATION

DE$4.8M$85vs $101 med0.84x57,26151,228
12
1811062763

MID ATLANTIC PEMANENTE MEDICAL GROUP

MD$4.6M$110vs $101 med1.09x42,00641,372
13
1952476988

MONTEFIORE MEDICAL CENTER

NY$4.6M$118vs $101 med1.17x39,16938,984
14
1346249430

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.

SC$4.5M$185vs $101 med1.83x24,54824,041
15
1548266547

BALTIMORE MEDICAL SYSTEM INC

MD$4.5M$229vs $101 med2.26x19,55617,788
16
1104802354

PRESBYTERIAN HEALTHCARE SERVICES

NM$4.2M$101vs $101 med1.00x41,51641,441
17
1144268277

COOPER PEDIATRICS

NJ$4.1M$160vs $101 med1.58x25,70225,180
18
1619969458

SUN RIVER HEALTH INC.

NY$4.0M$68vs $101 med0.67x58,03334,349
19
1538264429

EL CENTRO DEL BARRIO, INC.

TX$3.9M$72vs $101 med0.71x53,71753,069
20
1033494943

OUR LADY OF THE LAKE PHYSICIAN GROUP LLC

LA$3.6M$64vs $101 med0.63x57,11452,981
21
1821288606

HAPPY KIDS PEDIATRICS P.C.

AZ$3.6M$80vs $101 med0.79x44,93544,612
22
1720194053

PROHEALTH PHYSICIANS PC

CT$3.6M$112vs $101 med1.11x31,99930,143
23
1184016941

SOUTH CAROLINA PEDIATRICS ALLIANCE, LLC

SC$3.5M$97vs $101 med0.96x36,01435,018
24
1952690463

BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.

TX$3.5M$85vs $101 med0.84x40,78240,310
25
1912939703

CHILDREN'S HOSPITAL

DC$3.4M$197vs $101 med1.94x17,23816,174

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
1TX$231.2M$782,945,2542,872,6321,538
2NY$217.8M$673,244,0322,852,6271,560
3FL$159.0M$792,011,3051,852,9621,121
4NC$105.4M$861,220,6921,061,736588
5CA$86.5M$184,788,0794,298,9342,603
6OH$86.3M$671,283,3331,083,249477
7MI$67.9M$611,120,9971,100,660722
8TN$67.5M$71953,343832,895507
9MA$61.9M$85731,758724,679670
10MD$59.8M$111539,772502,628346
11SC$57.7M$103561,057551,346389
12NJ$56.8M$63897,444877,416589
13VA$49.0M$77633,920608,763627
14IL$44.0M$351,255,0011,101,4061,676
15IN$42.5M$81522,142463,815318
16PA$42.2M$69609,300596,778876
17LA$41.8M$50827,531745,198493
18AZ$41.2M$56740,039694,345312
19WA$33.0M$70469,467464,194315
20CO$32.4M$112288,821259,743293
21AL$31.4M$53594,166554,750320
22GA$29.5M$98301,186290,334173
23CT$27.2M$72379,854354,671180
24NM$25.5M$111229,436228,361124
25KY$25.3M$67378,007363,814316

57 rows · Page 1 of 3