Physician
Ocean Pulmonary Associates, P.A.
Ocean Pulmonary Associates, P.A. was paid $1.10M by Medicaid between Jan 2018 and Nov 2024, across 19 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 29% of everything it billed.
33Billing provider infoOCEAN PULMONARY ASSOCIATES, P.A.
TOMS RIVER, NJ 08755
TOMS RIVER, NJ 08755
33aNPI1174645154assigned 04/03/2007
33bProvider typePulmonary Disease Physician
28Total paid$1.10M
24GClaims34,212
24DCodes billed19
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in New Jersey
Rank by total paid#4 of 112
Median peer was paid$24K
This provider vs. median45×
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 | 3,627 | $130K | |
| 2019 | 3,812 | $153K | |
| 2020 | 5,030 | $170K | |
| 2021 | 5,415 | $174K | |
| 2022 | 5,758 | $166K | |
| 2023 | 6,436 | $184K | |
| 2024incomplete | 4,134 | $125K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 29% | 5,316 | 4,572 | $324K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 26% | 6,492 | 2,936 | $289K |
| 94010 | 19% | 8,295 | 7,754 | $206K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.7% | 1,944 | 1,710 | $85K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 7.2% | 2,859 | 1,365 | $80K |
| 94375 | 4.0% | 1,957 | 1,645 | $44K | |
| 99243 | 2.4% | 208 | 207 | $26K | |
| 99223 | Prolong inpt eval add15 m | 1.6% | 207 | 182 | $17K |
| 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% | 103 | 82 | $9K |
| 99406 | <1% | 683 | 603 | $6K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 27 | 27 | $5K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 27 | 12 | $5K |
7 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 62 | $4K |
| 93042 | <1% | 5,103 | $665.95 | |
| 95800 | <1% | 14 | $392.23 | |
| G0296 | Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) | <1% | 389 | $39.21 |
| 99306 | Prolong nursin fac eval 15m | <1% | 14 | $37.84 |
| 99072 | 0% | 464 | $0.00 | |
| 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) | 0% | 48 | $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.
From NPPES
Who's on the registration
Authorized officialKERR, BRIAN (PRESIDENT)