Pennsylvania Medicaid Spending
Pennsylvania's Medicaid program paid $3.24B across 16 providers from 2018–2024. 47 providers in Pennsylvania are flagged on our risk watchlist. The top procedure code is K0606 (Automated external defibrillator) at $504.0M.
Total Spending
$3.24B
Total Claims
37.2M
Top Providers
16
Beneficiaries
17.8M
Flagged Providers
47
on risk watchlist
Avg Per Provider
$202.5M
across 16 providers
Yearly Spending Trend
Top Providers in Pennsylvania
Zoll Services LLC
Durable Medical Equipment & Medical Supplies · Pittsburgh
$504.0M
478K claims
Commonwealth of Pennsylvania Department of Education
Local Education Agency (LEA) · West Hazleton
$326.0M
13.0M claims
Excel Copmanion Care INC
Home Health · Warminster
$308.4M
1.7M claims
Childrens Hospital of Philadelphia
General Acute Care Hospital Children · Philadelphia
$286.9M
1.7M claims
Procare Pharmacy Direct, Llc.
Pharmacy, Community/Retail Pharmacy · Monroeville
$227.3M
83K claims
Northeast Pennsylvania Center for Independent Living
Supports Brokerage · Scranton
$227.2M
3.2M claims
Tobii Dynavox LLC
Durable Medical Equipment & Medical Supplies, Cust · Coraopolis
$182.1M
64K claims
White Deer Run LLC
Community/Behavioral Health · Allenwood
$145.8M
464K claims
Patriot Home Care INC
Home Health · Philadelphia
$135.8M
824K claims
Quest Diagnostics of Pennsylvania, Inc.
Clinical Medical Laboratory · Pittsburgh
$132.4M
11.2M claims
Accredo Health Group INC
Pharmacy, Community/Retail Pharmacy · Warrendale
$130.9M
151K claims
Service Access and Management INC
Community/Behavioral Health · Reading
$128.9M
1.4M claims
Pyramid Health Care Inc.
Substance Abuse Rehabilitation Facility · Wilkinsburg
$128.8M
423K claims
Act Home Health Services INC
Home Health · Philadelphia
$126.0M
174K claims
Upmc Presbyterian Shadyside
Clinic/Center · Pittsburgh
$125.5M
1.7M claims
Wesley Family Services
Clinic/Center Mental Health (Including Community · Wilkinsburg
$123.4M
652K claims
Flagged Providers in Pennsylvania
Childrens Hospital of Philadelphia
$286.9M
2 flags
Red Lion Home Care
$17.2M
2 flags
Zoll Services LLC
$504.0M
1 flag
Commonwealth of Pennsylvania Department of Education
$326.0M
1 flag
Excel Copmanion Care INC
$308.4M
1 flag
Procare Pharmacy Direct, Llc.
$227.3M
1 flag
Northeast Pennsylvania Center for Independent Living
$227.2M
1 flag
White Deer Run LLC
$145.8M
1 flag
Patriot Home Care INC
$135.8M
1 flag
Pyramid Health Care Inc.
$128.8M
1 flag
Showing 10 of 47 flagged providers. View full risk watchlist
Spending by Top Procedures
Top Procedures in Pennsylvania
| Code | Total Paid |
|---|---|
| K0606 Automated external defibrillator | $504.0M |
| W1793 State-defined waiver service | $443.6M |
| H2036 Alcohol/drug treatment, per hour | $188.7M |
| E2510 Speech generating device, synthesized speech, multiple methods | $138.7M |
| S5126 Attendant care services, per diem | $135.5M |
| T1019 Personal care services, per 15 min | $117.4M |
| W7210 Waiver service, state-specific code | $76.9M |
| J0584 Burosumab-twza (Crysvita) injection, 1 mg | $72.4M |
| J3285 | $66.8M |
| T1017 Targeted case management, per 15 min | $61.0M |
| 97530 Therapeutic activities, each 15 min | $59.4M |
| 92507 Speech/hearing/language treatment | $56.2M |
| 99283 Emergency dept visit, moderate complexity | $56.2M |
| S9124 Nursing care, in the home; per hour | $48.0M |
| H0018 Behavioral health; short-term residential, per diem | $45.3M |