Sprouse, Gary

Sprouse, Gary was paid $905K by Medicaid between Jan 2018 and Dec 2023, across 6 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 76% of everything it billed.

33Billing provider infoSPROUSE, GARY
CHESTER, MD 21619

33aNPI1255443727assigned 08/31/2006

33bProvider typeInternal Medicine Physician

28Total paid$905K

24GClaims56,578

24DCodes billed6

24AFirst – last monthJan 2018 – Dec 2023

Compared with peers

Next to other Internal Medicine Physician providers in Maryland

Rank by total paid#48 of 501

Median peer was paid$77K

This provider vs. median12×

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	2,044	$137K
2019	4,010	$119K
2020	26,286	$215K
2021	9,907	$175K
2022	9,488	$145K
2023	4,843	$114K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99309	Subsequent nursing facility care, per day, low to moderate complexity	76%	33,891	7,357	$689K
99307		13%	19,380	703	$117K
99310	Prolong nursin fac eval 15m	4.4%	1,790	697	$40K
99306	Prolong nursin fac eval 15m	3.5%	1,130	591	$32K
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	2.4%	317	269	$21K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	<1%	70	66	$6K

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.