Physician
Gaps Health Wi LTD
Gaps Health Wi LTD was paid $18K by Medicaid between Nov 2020 and Jan 2023, across 7 billing codes. Its largest line is 99308, Subsequent nursing facility care, per day, straightforward — 54% of everything it billed.
33Billing provider infoGAPS HEALTH WI LTD
SOUTH MILWAUKEE, WI 53172
SOUTH MILWAUKEE, WI 53172
33aNPI1033760574assigned 09/26/2019
33bProvider typeGeneral Practice Physician
28Total paid$18K
24GClaims2,520
24DCodes billed7
24AFirst – last monthNov 2020 – Jan 2023
Compared with peers
Next to other General Practice Physician providers in Wisconsin
Rank by total paid#11 of 20
Median peer was paid$18K
This provider vs. median1.0×
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 | |
|---|---|---|---|
| 2020 | 490 | $363.84 | |
| 2021 | 1,669 | $14K | |
| 2022 | 327 | $3K | |
| 2023 | 34 | $290.08 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility care, per day, straightforward | 54% | 995 | 517 | $9K |
| 99305 | 17% | 735 | 587 | $3K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 13% | 205 | 98 | $2K |
| 99307 | 7.9% | 267 | 107 | $1K | |
| 99490 | Ccm add 20min | 7.3% | 257 | 243 | $1K |
| 99310 | Prolong nursin fac eval 15m | 1.4% | 29 | 23 | $251.49 |
| 99306 | Prolong nursin fac eval 15m | 0% | 32 | 28 | $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.
From NPPES
Who's on the registration
Authorized officialWILBORN, SONALI (PHYSICIAN)
| Provider | Location | Paid |
|---|---|---|
| Gaps Health FL | Fort Pierce, FL | $9K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.