SMGH Physician Practice Management, LLC
SMGH Physician Practice Management, LLC was paid $257K by Medicaid between Apr 2018 and Nov 2023, across 28 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 42% of everything it billed.
PASSAIC, NJ 07055
Next to other Internal Medicine Physician providers in New Jersey
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 101 | $3K | |
| 2019 | 226 | $7K | |
| 2020 | 331 | $10K | |
| 2021 | 1,766 | $65K | |
| 2022 | 2,846 | $83K | |
| 2023 | 9,531 | $88K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 42% | 3,475 | 3,087 | $109K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 29% | 2,788 | 1,904 | $74K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 8.2% | 353 | 310 | $21K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 7.6% | 285 | 280 | $19K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.7% | 445 | 405 | $7K |
| 43775 | 2.7% | 75 | 62 | $7K | |
| 99205 | Prolong outpt/office vis | 2.4% | 114 | 110 | $6K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 2.0% | 190 | 148 | $5K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.0% | 57 | 53 | $3K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 368 | 283 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 15 | 14 | $1K |
| 99442 | <1% | 64 | 55 | $702.01 |
16 more codes
| 99443 | <1% | 49 | $679.47 | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 39 | $423.88 |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 36 | $415.25 |
| 00812 | <1% | 12 | $319.83 | |
| 90686 | <1% | 45 | $214.16 | |
| 76813 | <1% | 23 | $121.91 | |
| 1126F | <1% | 930 | $28.00 | |
| 3074F | <1% | 806 | $28.00 | |
| 3008F | <1% | 1,457 | $20.00 | |
| 3078F | <1% | 779 | $20.00 | |
| 3079F | <1% | 401 | $16.00 | |
| 1160F | <1% | 1,621 | $4.00 | |
| 3077F | <1% | 79 | $4.00 | |
| 3075F | <1% | 145 | $3.00 | |
| 3725F | 0% | 109 | $0.00 | |
| 3288F | 0% | 41 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.