Physician
Pioneer Medical Associates P.C.
Pioneer Medical Associates P.C. was paid $2.95M by Medicaid between Jan 2019 and Dec 2024, across 82 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 30% of everything it billed.
33Billing provider infoPIONEER MEDICAL ASSOCIATES P.C.
CLINTON TWP, MI 48038
CLINTON TWP, MI 48038
33aNPI1093296592assigned 08/23/2018
33bProvider typeCardiovascular Disease Physician
28Total paid$2.95M
24GClaims88,505
24DCodes billed82
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Cardiovascular Disease Physician providers in Michigan
Rank by total paid#10 of 134
Median peer was paid$91K
This provider vs. median32×
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 | |
|---|---|---|---|
| 2019 | 7,660 | $235K | |
| 2020 | 11,873 | $369K | |
| 2021 | 16,120 | $479K | |
| 2022 | 18,630 | $547K | |
| 2023 | 20,727 | $751K | |
| 2024incomplete | 13,495 | $565K |
Box 24 · Service lines
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 | 30% | 16,607 | 15,683 | $884K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 16% | 11,145 | 3,178 | $458K |
| 99223 | Prolong inpt eval add15 m | 13% | 3,611 | 3,116 | $379K |
| 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 | 7.5% | 3,186 | 3,089 | $220K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 5.2% | 2,314 | 973 | $153K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 4.9% | 1,646 | 1,623 | $143K |
| 99222 | Initial hospital care, per day, moderate complexity | 4.4% | 1,755 | 1,534 | $129K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 3.6% | 1,330 | 1,318 | $106K |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.2% | 1,546 | 1,475 | $66K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 1.7% | 699 | 665 | $49K |
| 99385 | 1.2% | 382 | 378 | $36K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | 1.1% | 1,126 | 1,019 | $33K |
70 more codes
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.0% | 812 | $30K |
| 92552 | <1% | 1,399 | $27K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,129 | $23K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,694 | $18K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 189 | $16K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 210 | $15K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,391 | $13K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 217 | $12K |
| 90756 | <1% | 467 | $12K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,574 | $11K |
| 99386 | <1% | 76 | $9K | |
| 43235 | <1% | 411 | $8K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 436 | $8K |
| 81025 | <1% | 1,060 | $7K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 85 | $6K |
| 93000 | <1% | 847 | $6K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 124 | $5K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,250 | $5K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 306 | $5K |
| 80061 | Lipid panel | <1% | 1,042 | $5K |
| 99304 | <1% | 117 | $4K | |
| 90686 | <1% | 283 | $4K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,246 | $4K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 53 | $4K |
| 99442 | <1% | 179 | $3K | |
| 82947 | <1% | 1,381 | $3K | |
| 90661 | <1% | 109 | $3K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 626 | $2K |
| 80053 | Comprehensive metabolic panel | <1% | 575 | $2K |
| 85018 | <1% | 991 | $2K | |
| 99497 | <1% | 41 | $1K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 14 | $1K |
| 93978 | <1% | 13 | $1K | |
| 99384 | <1% | 12 | $1K | |
| 81003 | <1% | 735 | $1K | |
| 80051 | <1% | 533 | $1K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 13 | $1K |
| 83735 | <1% | 541 | $1K | |
| 99234 | <1% | 15 | $867.75 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 865 | $790.16 |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 13 | $766.45 |
| 90688 | <1% | 47 | $717.89 | |
| 82565 | <1% | 467 | $671.28 | |
| 84520 | <1% | 537 | $623.78 | |
| 84100 | <1% | 482 | $620.74 | |
| 84550 | <1% | 511 | $583.72 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 268 | $507.96 |
| 81000 | <1% | 138 | $426.32 | |
| 81002 | <1% | 145 | $339.28 | |
| 99443 | <1% | 16 | $338.70 | |
| 90674 | <1% | 36 | $300.00 | |
| 90694 | <1% | 12 | $218.36 | |
| 94060 | <1% | 12 | $159.46 | |
| 82607 | <1% | 82 | $68.82 | |
| G0008 | Administration of influenza virus vaccine | <1% | 29 | $48.39 |
| 84439 | <1% | 59 | $32.88 | |
| 84480 | <1% | 14 | $23.48 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 13 | $7.71 |
| 3074F | <1% | 3,854 | $7.52 | |
| 3078F | <1% | 2,730 | $5.43 | |
| 3079F | <1% | 2,363 | $4.66 | |
| 3075F | <1% | 960 | $2.00 | |
| 3077F | <1% | 810 | $1.81 | |
| 3080F | <1% | 558 | $1.03 | |
| 94760 | <1% | 68 | $0.53 | |
| 84450 | <1% | 12 | $0.41 | |
| 3048F | <1% | 38 | $0.02 | |
| 3044F | 0% | 774 | $0.00 | |
| 90734 | 0% | 28 | $0.00 | |
| 90687 | 0% | 21 | $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 officialIBRAHIM, GHAITH (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Warren Gastroenterology PC | Warren, MI | $314K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.