Physician
Congenial Healthcare, LLC
Congenial Healthcare, LLC was paid $24K by Medicaid between Jan 2018 and Dec 2022, across 4 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 99% of everything it billed.
33Billing provider infoCONGENIAL HEALTHCARE, LLC
WAKEFIELD, MA 01880
WAKEFIELD, MA 01880
33aNPI1033620372assigned 10/13/2017
33bProvider typeInternal Medicine Physician
28Total paid$24K
24GClaims605
24DCodes billed4
24AFirst – last monthJan 2018 – Dec 2022
Compared with peers
Next to other Internal Medicine Physician providers in Massachusetts
Rank by total paid#449 of 1,270
Median peer was paid$8K
This provider vs. median2.9×
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.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 132 | $6K | |
| 2019 | 218 | $8K | |
| 2020 | 54 | $2K | |
| 2021 | 115 | $4K | |
| 2022 | 86 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 99% | 443 | 423 | $24K |
| 81002 | <1% | 125 | 120 | $159.51 | |
| 80053 | Comprehensive metabolic panel | <1% | 25 | 25 | $76.59 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 12 | 12 | $40.05 |
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.
From NPPES
Who's on the registration
Authorized officialREDDY, PRATHIMA (PHYSICIAN)
Parent organizationCONGENIAL HEALTHCARE, LLC