Pineles, Edward

Pineles, Edward was paid $371K by Medicaid between Jan 2018 and Nov 2024, across 25 billing codes. Its largest line is 95004, Percutaneous tests with allergenic extracts, immediate type reaction — 43% of everything it billed.

33Billing provider infoPINELES, EDWARD
MIDDLE VILLAGE, NY 11379

33aNPI1144204215assigned 12/02/2005

33bProvider typeInternal Medicine Physician

28Total paid$371K

24GClaims8,532

24DCodes billed25

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Internal Medicine Physician providers in New York

Rank by total paid#584 of 6,049

Median peer was paid$11K

This provider vs. median33×

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	1,298	$127K
2019	905	$56K
2020	1,380	$53K
2021	1,119	$43K
2022	1,299	$32K
2023	1,498	$39K
2024incomplete	1,033	$22K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
95004	Percutaneous tests with allergenic extracts, immediate type reaction	43%	797	736	$160K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	20%	3,133	1,170	$73K
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	9.8%	352	349	$36K
99222	Initial hospital care, per day, moderate complexity	5.4%	909	859	$20K
94060		4.2%	471	457	$16K
99306	Prolong nursin fac eval 15m	3.4%	366	358	$13K
94729		2.8%	359	347	$10K
94727		2.7%	438	417	$10K
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	2.1%	113	100	$8K
94010		2.0%	364	355	$7K
99308	Subsequent nursing facility care, per day, straightforward	1.6%	519	445	$6K
93229		1.3%	14	14	$5K

13 more codes

94621		<1%	16	$2K
99309	Subsequent nursing facility care, per day, low to moderate complexity	<1%	45	$1K
99213	Doctor's office visit, returning patient (routine)	<1%	17	$1K
94200		<1%	172	$1K
94375		<1%	288	$862.79
99443		<1%	18	$636.25
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	57	$400.08
99305		<1%	14	$111.90
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	14	$0.00
1123F		0%	15	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	13	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	15	$0.00
G8421	Bmi not documented and no reason is given	0%	13	$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.