Prime Healthcare, PC

Prime Healthcare, PC was paid $4.27M by Medicaid between Jan 2018 and Dec 2024, across 80 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 48% of everything it billed.

33Billing provider infoPRIME HEALTHCARE, PC
WETHERSFIELD, CT 06109

33aNPI1184819302assigned 09/11/2007

33bProvider typeCritical Care Medicine (Internal Medicine) Physician

28Total paid$4.27M

24GClaims204,600

24DCodes billed80

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Critical Care Medicine (Internal Medicine) Physician providers in Connecticut

Rank by total paid#2 of 13

Median peer was paid$12K

This provider vs. median365×

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	30,813	$581K
2019	27,965	$591K
2020	21,583	$468K
2021	27,966	$582K
2022	34,277	$697K
2023	34,886	$725K
2024incomplete	27,110	$630K

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	48%	42,172	37,801	$2.07M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	27%	32,973	28,924	$1.16M
99308	Subsequent nursing facility care, per day, straightforward	5.8%	6,863	6,121	$248K
99349		4.5%	5,412	4,290	$191K
99305		1.7%	1,080	967	$72K
99309	Subsequent nursing facility care, per day, low to moderate complexity	1.4%	1,221	1,061	$60K
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	1.2%	1,017	933	$49K
99307		1.0%	2,435	2,299	$45K
99223	Prolong inpt eval add15 m	<1%	525	486	$36K
99336		<1%	932	658	$31K
99244	Office or other outpatient consultation, moderate to high complexity	<1%	263	240	$29K
99487	Ccm add 20min	<1%	1,627	1,599	$29K

68 more codes

99215	Doctor's office visit, returning patient (complex)	<1%	432	$21K
76770		<1%	783	$20K
99232	Hospital visit by a doctor, follow-up day	<1%	956	$19K
G0179	Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	<1%	1,970	$18K
94010		<1%	1,737	$14K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	91	$12K
82570		<1%	4,263	$11K
99489	Ccm add 20min	<1%	527	$10K
99350	Prolong home eval add 15m	<1%	257	$9K
83036	Hemoglobin; glycosylated (A1C)	<1%	2,313	$9K
99490	Ccm add 20min	<1%	1,063	$9K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	66	$9K
G0180	Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	<1%	759	$9K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	374	$8K
99203	Doctor's office visit, new patient (routine)	<1%	124	$7K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	165	$7K
99491	Ccm add 20min	<1%	399	$6K
51798		<1%	1,215	$6K
96127		<1%	283	$5K
90674		<1%	236	$5K
99245		<1%	31	$4K
82962		<1%	4,458	$4K
94729		<1%	568	$4K
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	105	$3K
93000		<1%	341	$3K
99233	Hospital visit by a doctor, follow-up day (complex)	<1%	83	$3K
94375		<1%	607	$3K
99254		<1%	31	$3K
94727		<1%	441	$3K
99306	Prolong nursin fac eval 15m	<1%	26	$3K
95251		<1%	228	$2K
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	172	$2K
52000		<1%	26	$1K
99442		<1%	55	$1K
90686		<1%	193	$989.56
99497		<1%	63	$765.82
99222	Initial hospital care, per day, moderate complexity	<1%	14	$660.33
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	<1%	17	$569.00
94060		<1%	65	$475.02
81003		<1%	1,298	$471.90
90756		<1%	30	$468.61
95800		<1%	14	$405.54
99337		<1%	15	$390.70
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	13	$290.16
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%	113	$224.02
98926		<1%	13	$215.19
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	333	$171.29
99173		<1%	13	$91.20
81002		<1%	273	$90.28
3017F		0%	4,012	$0.00
1036F		0%	9,145	$0.00
G8419	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	0%	20,629	$0.00
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	0%	1,157	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	7,486	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	469	$0.00
G8755	Most recent diastolic blood pressure >= 90 mmhg	0%	130	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	0%	187	$0.00
3044F		0%	37	$0.00
G0008	Administration of influenza virus vaccine	0%	41	$0.00
G8783	Normal blood pressure reading documented, follow-up not required	0%	27,781	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	3,403	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	0%	5,538	$0.00
G8753	Most recent systolic blood pressure >= 140 mmhg	0%	139	$0.00
1033F		0%	12	$0.00
G8482	Influenza immunization administered or previously received	0%	196	$0.00
G8483	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	0%	40	$0.00
3045F		0%	12	$0.00
G0444	Annual depression screening, 5 to 15 minutes	0%	14	$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 officialALBANO, SUSAN (CEO)