Upstate Gastroenterology Associates, PC

Upstate Gastroenterology Associates, PC was paid $78K by Medicaid between Jan 2018 and Oct 2024, across 10 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 42% of everything it billed.

33Billing provider infoUPSTATE GASTROENTEROLOGY ASSOCIATES, PC
TROY, NY 12180

33aNPI1255355830assigned 07/27/2006

33bProvider typeGastroenterology Physician

28Total paid$78K

24GClaims1,769

24DCodes billed10

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Gastroenterology Physician providers in New York

Rank by total paid#187 of 656

Median peer was paid$12K

This provider vs. median6.5×

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	106	$4K
2019	146	$7K
2020	380	$16K
2021	192	$8K
2022	415	$19K
2023	327	$15K
2024incomplete	203	$10K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	42%	332	332	$33K
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	24%	268	266	$19K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	11%	124	124	$9K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	8.4%	131	129	$7K
99152		6.5%	720	710	$5K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	3.2%	72	39	$3K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	1.2%	14	14	$947.35
44361		1.1%	12	12	$902.34
99222	Initial hospital care, per day, moderate complexity	<1%	12	12	$676.72
99153	Mod sedat endo service >5yrs	<1%	84	84	$582.00

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 officialBRAUNSTEIN, FREDERICK (CEO)