Kespra Medical Center LLC

Kespra Medical Center LLC was paid $291K by Medicaid between Jan 2018 and Nov 2024, across 37 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 62% of everything it billed.

33Billing provider infoKESPRA MEDICAL CENTER LLC
EDISON, NJ 08820

33aNPI1043517857assigned 02/15/2011

33bProvider typeHealth Maintenance Organization

28Total paid$291K

24GClaims17,928

24DCodes billed37

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Health Maintenance Organization providers in New Jersey

Rank by total paid#7 of 10

Median peer was paid$756K

This provider vs. median0.4×

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	1,976	$56K
2019	1,908	$43K
2020	1,726	$28K
2021	2,473	$35K
2022	3,510	$45K
2023	3,991	$51K
2024incomplete	2,344	$33K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	62%	7,119	5,514	$182K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	13%	2,276	1,838	$37K
99308	Subsequent nursing facility care, per day, straightforward	11%	1,398	547	$33K
99401		6.5%	930	896	$19K
99454		1.4%	1,350	1,162	$4K
99457		1.4%	1,687	1,438	$4K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	279	239	$3K
90674		<1%	133	126	$2K
99497		<1%	206	171	$1K
90756		<1%	165	125	$1K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	12	12	$892.12
90688		<1%	87	85	$717.14

25 more codes

96103		<1%	61	$550.61
90658		<1%	33	$535.82
94060		<1%	51	$463.65
96127		<1%	222	$432.30
90661		<1%	48	$405.35
90694		<1%	23	$265.72
99490	Ccm add 20min	<1%	53	$235.80
99458		<1%	184	$159.02
93922		<1%	15	$142.86
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	31	$117.79
3078F		<1%	331	$101.17
96130		<1%	13	$99.00
G0008	Administration of influenza virus vaccine	<1%	162	$80.50
3074F		<1%	146	$45.00
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	18	$31.56
3044F		<1%	111	$9.00
1170F		<1%	28	$8.02
1160F		<1%	12	$4.00
1125F		<1%	27	$2.02
3077F		<1%	15	$2.00
3725F		0%	618	$0.00
G0444	Annual depression screening, 5 to 15 minutes	0%	13	$0.00
99453		0%	45	$0.00
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	0%	13	$0.00
G0442	Annual alcohol misuse screening, 5 to 15 minutes	0%	13	$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 officialPATEL, PULIN (MD/PRESIDENT)

Same official

Other billing entities under PATEL, PULIN

Full network →

Provider	Location	Paid
Allergy and Asthma Physicians of Commerce Township	Mount Clemens, MI	$5.40M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.