Compared to Internal Medicine Peers
Total spending distribution among 26 providers in this specialty
This provider's total spending of $178K is at the 25th percentile among 26 Internal Medicine providers.
Total Paid
$178K
$177,555
Total Claims
5,118
Beneficiaries
1,453
3.5 claims/patient
Avg Cost/Claim
$35
🔍 Analysis
Provider Overview
Guy Clark is a Internal Medicine provider based in Knoxville, TN. From 2018-11 through 2019-08, this provider received $178K in Medicaid payments across 5K claims serving 1K beneficiaries, billing 5 distinct procedure codes.
Key Findings
- 📊Bills 2.3× the national median for H0047 (H0047), at $187 per claim vs. the median of $81, placing them above the 75th percentile.
- 📊Spending grew 2021% from $8K in 2018 to $170K in 2019.
- 📊Saw a 21.2× spike in 2019 ($8K → $170K), a sharp year-over-year increase.
- 📊Billing stopped in 2019-08, suggesting this provider is no longer active in Medicaid. Abrupt cessation of billing can be a risk indicator.
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 5 distinct procedure codes. The top code (H0047 (Alcohol and/or drug abuse, not otherwise specified)) accounts for 59% of total spending.
$105K
559 claims
$187.33
$81.37
Alcohol and/or drug abuse, not otherwise specified
$105K
559 claims · 59.0%
$62K
697 claims
$88.76
$31.37
Oral medication administration, direct observation
$62K
697 claims · 34.8%
$8K
1,967 claims
$3.92
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$8K
1,967 claims · 4.3%
$2K
1,165 claims
$1.95
$137.85
Other specified case management service, per 15 minutes
$2K
1,165 claims · 1.3%
$993
730 claims
$1.36
$25.06
Office/outpatient visit, low complexity
$993
730 claims · 0.6%
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