Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Clinic

Medical Specialties PLLC

Medical Specialties PLLC was paid $19K by Medicaid between Jun 2024 and Nov 2024, across 12 billing codes. Its largest line is 99497, — 31% of everything it billed.

33Billing provider infoMEDICAL SPECIALTIES PLLC
DECATUR, TN 37322
33aNPI1265294300assigned 01/24/2024
28Total paid$19K
24GClaims1,365
24DCodes billed12
24AFirst – last monthJun 2024 – Nov 2024
Compared with peers

Next to other Medical Specialty Clinic/Center providers in Tennessee

Rank by total paid#12 of 15
Median peer was paid$56K
This provider vs. median0.3×

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

$0$2.0K$4.0K$6.0K2018201920202021202220232024
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
YearClaimsPaid
2024incomplete1,365$19K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99497 31% 171 148 $6K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 23% 77 72 $4K
99490 Ccm add 20min 20% 366 271 $4K
96160 9.0% 169 147 $2K
G0442 Annual alcohol misuse screening, 5 to 15 minutes 5.1% 177 146 $962.42
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 4.8% 74 45 $912.65
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 3.5% 67 55 $656.95
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes 1.9% 178 147 $351.79
99407 1.6% 23 21 $302.10
99406 <1% 16 14 $79.80
36415 Collection of venous blood by venipuncture <1% 15 14 $20.10
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) 0% 32 19 $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 officialROBERTS, ENGLISH (OWNER)
Same official

Other billing entities under ROBERTS, ENGLISH

Full network →
ProviderLocationPaid
Restoration ClinicDecatur, TN$1.42M
Restoration ClinicDecatur, TN$18K
Restoration ClinicDecatur, TN$233.22

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.