Physician
Congenial Healthcare, LLC
Congenial Healthcare, LLC was paid $578K by Medicaid between Jan 2018 and Jan 2021, across 24 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 66% of everything it billed.
33Billing provider infoCONGENIAL HEALTHCARE, LLC
MIDDLETON, MA 01949
MIDDLETON, MA 01949
33aNPI1063923399assigned 10/13/2017
33bProvider typeAdult Medicine Physician
28Total paid$578K
24GClaims17,177
24DCodes billed24
24AFirst – last monthJan 2018 – Jan 2021
Compared with peers
Next to other Adult Medicine Physician providers in Massachusetts
Rank by total paid#3 of 11
Median peer was paid$74K
This provider vs. median7.8×
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 | 5,317 | $142K | |
| 2019 | 5,915 | $175K | |
| 2020 | 5,931 | $260K | |
| 2021 | 14 | $1K |
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 | 66% | 7,672 | 6,666 | $381K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 29% | 3,761 | 3,440 | $167K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.0% | 127 | 125 | $6K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,574 | 1,484 | $6K |
| 90674 | <1% | 265 | 265 | $4K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 364 | 354 | $4K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 191 | 189 | $3K |
| ATP18 | <1% | 366 | 357 | $2K | |
| 80061 | Lipid panel | <1% | 671 | 655 | $1K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 908 | 865 | $949.99 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 29 | 28 | $939.17 |
| ATP15 | <1% | 171 | 167 | $660.72 |
12 more codes
| 80076 | <1% | 498 | $512.62 | |
| ATP14 | <1% | 107 | $470.23 | |
| ATP08 | <1% | 107 | $226.98 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 24 | $192.21 |
| 96127 | <1% | 144 | $178.74 | |
| 99050 | <1% | 13 | $165.60 | |
| 93000 | <1% | 13 | $92.54 | |
| 80053 | Comprehensive metabolic panel | <1% | 28 | $40.26 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 13 | $35.44 |
| G0008 | Administration of influenza virus vaccine | <1% | 106 | $22.84 |
| 96160 | <1% | 13 | $11.69 | |
| 99000 | <1% | 12 | $1.00 |
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 officialALLARA, MARK (PARTNER)
Parent organizationCONGENIAL HEALTHCARE, LLC
| Provider | Location | Paid |
|---|---|---|
| Middleton Family Medicine Urgent Care, LLC | Middleton, MA | $1.43M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.