Physician
Sumner Physician Practices
Sumner Physician Practices was paid $1.24M by Medicaid between Jan 2018 and Dec 2024, across 65 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 42% of everything it billed.
33Billing provider infoSUMNER PHYSICIAN PRACTICES
CARTHAGE, TN 37030
CARTHAGE, TN 37030
33aNPI1093251217assigned 01/11/2017
33bProvider typeObstetrics & Gynecology Physician
28Total paid$1.24M
24GClaims71,845
24DCodes billed65
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in Tennessee
Rank by total paid#21 of 176
Median peer was paid$39K
This provider vs. median31×
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.
Entity ProliferationAuthorized official LAWRENCE, CHARLOTTE controls 20+ related entities in our dataset. Read more
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 | 5,578 | $96K | |
| 2019 | 7,054 | $174K | |
| 2020 | 6,169 | $157K | |
| 2021 | 7,538 | $223K | |
| 2022 | 20,674 | $218K | |
| 2023 | 10,717 | $184K | |
| 2024incomplete | 14,115 | $185K |
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 | 42% | 13,218 | 10,447 | $516K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 40% | 15,426 | 12,483 | $497K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.0% | 1,136 | 920 | $75K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.2% | 1,236 | 976 | $40K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 2.0% | 265 | 221 | $25K |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.2% | 554 | 467 | $15K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.1% | 2,086 | 1,588 | $14K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.0% | 165 | 147 | $13K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 468 | 180 | $6K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 470 | 400 | $5K |
| 81003 | <1% | 3,530 | 2,411 | $5K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 191 | 151 | $5K |
53 more codes
| 99221 | <1% | 161 | $4K | |
| 90686 | <1% | 359 | $3K | |
| 90678 | <1% | 16 | $2K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 166 | $1K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 926 | $1K |
| 87428 | <1% | 25 | $1K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 57 | $1K |
| 81025 | <1% | 233 | $1K | |
| 90688 | <1% | 127 | $909.83 | |
| 99217 | <1% | 33 | $763.74 | |
| 90670 | <1% | 314 | $671.53 | |
| 3078F | <1% | 3,143 | $460.00 | |
| 99442 | <1% | 51 | $441.56 | |
| 3074F | <1% | 3,213 | $422.95 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 230 | $411.43 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 27 | $334.71 |
| 90656 | <1% | 29 | $300.60 | |
| 3079F | <1% | 1,072 | $300.00 | |
| 90674 | <1% | 17 | $260.06 | |
| 90461 | <1% | 574 | $250.86 | |
| G0008 | Administration of influenza virus vaccine | <1% | 369 | $192.31 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 36 | $141.98 |
| 99441 | <1% | 26 | $124.79 | |
| 3077F | <1% | 353 | $90.00 | |
| 82044 | <1% | 99 | $86.77 | |
| 90698 | <1% | 126 | $55.20 | |
| 3075F | <1% | 133 | $40.00 | |
| 82962 | <1% | 40 | $31.32 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 50 | $24.13 |
| 81002 | <1% | 23 | $16.86 | |
| 99173 | <1% | 12 | $10.45 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 30 | $8.38 |
| 1160F | 0% | 3,636 | $0.00 | |
| 1159F | 0% | 3,634 | $0.00 | |
| 90653 | 0% | 75 | $0.00 | |
| 0502F | 0% | 1,335 | $0.00 | |
| 90633 | 0% | 12 | $0.00 | |
| 3725F | 0% | 95 | $0.00 | |
| 90671 | 0% | 54 | $0.00 | |
| 3008F | 0% | 6,440 | $0.00 | |
| 0503F | 0% | 20 | $0.00 | |
| 1126F | 0% | 230 | $0.00 | |
| 1034F | 0% | 1,406 | $0.00 | |
| 1036F | 0% | 3,546 | $0.00 | |
| 90677 | 0% | 35 | $0.00 | |
| 1125F | 0% | 205 | $0.00 | |
| 90694 | 0% | 74 | $0.00 | |
| 90744 | 0% | 25 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 12 | $0.00 |
| 90680 | 0% | 155 | $0.00 | |
| 0500F | 0% | 12 | $0.00 | |
| 90697 | 0% | 15 | $0.00 | |
| 0501F | 0% | 14 | $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 officialLAWRENCE, CHARLOTTE (SECRETARY)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.