Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Pratt Medical Group, INC

Pratt Medical Group, INC was paid $247K by Medicaid between Jan 2018 and Oct 2024, across 11 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 61% of everything it billed.

33Billing provider infoPRATT MEDICAL GROUP, INC
BOSTON, MA 02111
33aNPI1104146992assigned 06/03/2010
28Total paid$247K
24GClaims9,282
24DCodes billed11
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers

Next to other Endocrinology, Diabetes & Metabolism Physician providers in Massachusetts

Rank by total paid#2 of 60
Median peer was paid$6K
This provider vs. median41×

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 GALLEGOS, EDWARD controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$5.0K$10K$15K2018201920202021202220232024
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
YearClaimsPaid
2018829$27K
20191,026$27K
2020999$32K
20211,213$36K
20221,609$44K
20232,180$54K
2024incomplete1,426$27K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 61% 4,695 4,610 $152K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 18% 2,541 938 $45K
99222 Initial hospital care, per day, moderate complexity 8.9% 731 694 $22K
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 6.6% 324 316 $16K
99223 Prolong inpt eval add15 m 1.3% 82 81 $3K
99231 Subsequent hospital care, per day, straightforward or low complexity 1.0% 207 96 $3K
95251 <1% 187 182 $2K
99443 <1% 107 103 $2K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 346 344 $1K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity <1% 17 15 $329.18
83036 Hemoglobin; glycosylated (A1C) <1% 45 45 $276.60

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 officialGALLEGOS, EDWARD (DIRECTOR)
Same official

Other billing entities under GALLEGOS, EDWARD

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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.