Bluefield Gastroenterology PLLC
Bluefield Gastroenterology PLLC was paid $4.02M by Medicaid between Jan 2018 and Dec 2024, across 31 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 23% of everything it billed.
33Billing provider infoBLUEFIELD GASTROENTEROLOGY PLLC
PRINCETON, WV 24740
PRINCETON, WV 24740
33aNPI1093869968assigned 01/22/2007
33bProvider typeSpecialist
28Total paid$4.02M
24GClaims50,902
24DCodes billed31
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in West Virginia
Rank by total paid#6 of 71
Median peer was paid$232K
This provider vs. median17×
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 | 11,463 | $1.08M | |
| 2019 | 5,568 | $394K | |
| 2020 | 9,771 | $939K | |
| 2021 | 9,162 | $565K | |
| 2022 | 6,378 | $376K | |
| 2023 | 4,557 | $328K | |
| 2024incomplete | 4,003 | $334K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 23% | 5,337 | 5,028 | $928K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 16% | 5,418 | 4,664 | $623K |
| 88313 | 12% | 4,063 | 3,736 | $493K | |
| 88312 | 10% | 4,065 | 3,734 | $420K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 9.1% | 9,029 | 8,653 | $364K |
| 00731 | 7.5% | 2,667 | 2,532 | $300K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.3% | 5,661 | 5,432 | $131K |
| 45384 | 2.5% | 390 | 358 | $101K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 2.0% | 2,061 | 2,017 | $82K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 2.0% | 392 | 321 | $80K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.8% | 1,117 | 1,071 | $72K |
| 00811 | 1.7% | 537 | 508 | $68K |
19 more codes
| 99222 | Initial hospital care, per day, moderate complexity | 1.5% | 962 | $61K |
| 99232 | Hospital visit by a doctor, follow-up day | 1.5% | 1,485 | $60K |
| 91200 | 1.0% | 1,861 | $42K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 1.0% | 576 | $41K |
| 99152 | <1% | 1,885 | $33K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 287 | $30K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 95 | $21K |
| 00812 | <1% | 227 | $17K | |
| 99205 | Prolong outpt/office vis | <1% | 113 | $15K |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | <1% | 270 | $8K |
| 81025 | <1% | 801 | $6K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 65 | $5K |
| 43235 | <1% | 71 | $5K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 52 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 327 | $3K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 13 | $3K |
| 82947 | <1% | 861 | $2K | |
| 99153 | Mod sedat endo service >5yrs | <1% | 199 | $449.19 |
| 82962 | <1% | 15 | $44.25 |
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, KAMALESH (OWNER)