Sumner Physician Practices LLC
Sumner Physician Practices LLC was paid $16K by Medicaid between Nov 2018 and Aug 2023, across 11 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 68% of everything it billed.
HENDERSONVILLE, TN 37075
Next to other Gastroenterology 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 | 56 | $192.62 | |
| 2019 | 94 | $2K | |
| 2021 | 32 | $1K | |
| 2022 | 441 | $3K | |
| 2023 | 788 | $10K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 68% | 216 | 164 | $11K |
| 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 | 8.8% | 28 | 26 | $1K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 8.5% | 32 | 29 | $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 | 7.6% | 131 | 115 | $1K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 6.6% | 41 | 28 | $1K |
| 3074F | 0% | 59 | 49 | $0.00 | |
| 3008F | 0% | 252 | 196 | $0.00 | |
| 1036F | 0% | 137 | 110 | $0.00 | |
| 1159F | 0% | 249 | 191 | $0.00 | |
| 1160F | 0% | 249 | 191 | $0.00 | |
| 3078F | 0% | 17 | 12 | $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.