Physician
Nautilus Health Care Group, PLC
Nautilus Health Care Group, PLC was paid $261K by Medicaid between Jan 2018 and Nov 2024, across 14 billing codes. Its largest line is 11042, Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm — 45% of everything it billed.
33Billing provider infoNAUTILUS HEALTH CARE GROUP, PLC
SOMERSET, KY 42503
SOMERSET, KY 42503
33aNPI1164866877assigned 04/24/2013
33bProvider typeSurgery Physician
28Total paid$261K
24GClaims17,813
24DCodes billed14
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Surgery Physician providers in Kentucky
Rank by total paid#7 of 34
Median peer was paid$20K
This provider vs. median13×
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 | 2,880 | $44K | |
| 2019 | 2,830 | $41K | |
| 2020 | 3,292 | $39K | |
| 2021 | 3,281 | $48K | |
| 2022 | 2,454 | $37K | |
| 2023 | 1,519 | $26K | |
| 2024incomplete | 1,557 | $24K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 45% | 7,024 | 3,765 | $117K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 32% | 5,381 | 3,252 | $83K |
| 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 | 8.7% | 1,070 | 732 | $23K |
| 97597 | 5.8% | 1,219 | 645 | $15K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 2.9% | 1,860 | 468 | $7K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.7% | 112 | 101 | $5K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.7% | 247 | 128 | $4K |
| 17250 | <1% | 274 | 173 | $2K | |
| 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 | <1% | 45 | 40 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 43 | 38 | $673.72 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 393 | 127 | $596.92 |
| 11045 | <1% | 60 | 40 | $467.92 |
2 more codes
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 officialBASSIN, DAVID (CEO)