Lab
Digestive Disease Care, PC
Digestive Disease Care, PC was paid $1.75M by Medicaid between Jan 2018 and Nov 2024, across 49 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 45% of everything it billed.
33Billing provider infoDIGESTIVE DISEASE CARE, PC
EAST SETAUKET, NY 11733
EAST SETAUKET, NY 11733
33aNPI1184871774assigned 08/26/2008
33bProvider typeClinical Medical Laboratory
28Total paid$1.75M
24GClaims40,223
24DCodes billed49
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Clinical Medical Laboratory providers in New York
Rank by total paid#49 of 116
Median peer was paid$618K
This provider vs. median2.8×
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 | 1,383 | $134K | |
| 2019 | 1,484 | $86K | |
| 2020 | 1,339 | $70K | |
| 2021 | 8,165 | $309K | |
| 2022 | 14,252 | $451K | |
| 2023 | 9,492 | $396K | |
| 2024incomplete | 4,108 | $309K |
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 | 45% | 8,764 | 8,358 | $791K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 13% | 3,397 | 3,250 | $231K |
| 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 | 9.2% | 1,224 | 1,224 | $161K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 7.5% | 983 | 976 | $132K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 7.4% | 2,525 | 2,409 | $130K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 6.7% | 1,524 | 1,469 | $117K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | 1.6% | 1,620 | 1,550 | $28K |
| 88342 | 1.6% | 924 | 912 | $27K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.3% | 573 | 554 | $22K |
| 99487 | Ccm add 20min | 1.2% | 251 | 251 | $20K |
| 88313 | 1.1% | 929 | 917 | $19K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 147 | 147 | $13K |
37 more codes
| 88341 | <1% | 400 | $11K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 68 | $10K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 335 | $7K |
| 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% | 430 | $7K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 38 | $6K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 113 | $5K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 76 | $4K |
| 99243 | <1% | 28 | $3K | |
| 36000 | <1% | 238 | $2K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 387 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12 | $1K |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,681 | $1K |
| 99051 | <1% | 301 | $805.93 | |
| 86328 | <1% | 14 | $633.22 | |
| 99401 | <1% | 26 | $622.89 | |
| 90756 | <1% | 19 | $525.97 | |
| 93000 | <1% | 26 | $374.09 | |
| 96160 | <1% | 145 | $294.01 | |
| 86413 | <1% | 33 | $270.89 | |
| 99072 | <1% | 11,538 | $232.50 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 19 | $224.20 |
| 80076 | <1% | 56 | $204.53 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 40 | $179.90 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 13 | $177.60 |
| 81025 | <1% | 24 | $169.96 | |
| 80061 | Lipid panel | <1% | 44 | $153.52 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 74 | $135.95 |
| 82607 | <1% | 18 | $118.38 | |
| 86141 | <1% | 19 | $95.86 | |
| 82728 | <1% | 15 | $87.10 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 20 | $62.05 |
| 83690 | <1% | 17 | $48.69 | |
| 84439 | <1% | 26 | $48.52 | |
| 82150 | <1% | 13 | $38.15 | |
| 83550 | <1% | 13 | $37.26 | |
| 83540 | <1% | 13 | $35.42 | |
| 99173 | <1% | 30 | $3.66 |
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 officialMEHTA, NILESH (DOCTOR)
| Provider | Location | Paid |
|---|---|---|
| Nhpe, LLC | New Hyde Park, NY | $3.00M |
| New Hyde Park Medical P.C. | New Hyde Park, NY | $20K |
| Nilesh Mehta MD PLLC | El Paso, TX | $225.47 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.