Sumner Physician Practices LLC
Sumner Physician Practices LLC was paid $142K by Medicaid between Jan 2018 and Dec 2021, across 13 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 61% of everything it billed.
GALLATIN, TN 37066
Next to other Obstetrics & Gynecology Physician providers in Tennessee
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 | 1,982 | $36K | |
| 2019 | 2,079 | $36K | |
| 2020 | 1,679 | $28K | |
| 2021 | 2,094 | $42K |
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 | 61% | 2,138 | 1,772 | $86K |
| 81025 | 12% | 3,440 | 2,873 | $18K | |
| 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% | 168 | 138 | $11K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 6.8% | 133 | 112 | $10K |
| 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 | 5.8% | 180 | 160 | $8K |
| 59025 | Fetal non-stress test | 2.5% | 176 | 110 | $4K |
| 81003 | 1.5% | 1,281 | 978 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 89 | 67 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 112 | 95 | $1K |
| 90756 | <1% | 30 | 30 | $649.31 | |
| 87210 | <1% | 29 | 26 | $102.69 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 43 | 36 | $23.97 |
1 more codes
| 0503F | 0% | 15 | $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.