Physician
Pratt Medical Group, INC
Pratt Medical Group, INC was paid $2.18M by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 60% of everything it billed.
33Billing provider infoPRATT MEDICAL GROUP, INC
BOSTON, MA 02111
BOSTON, MA 02111
33aNPI1275570319assigned 05/31/2006
33bProvider typeNephrology Physician
28Total paid$2.18M
24GClaims64,590
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Nephrology Physician providers in Massachusetts
Rank by total paid#1 of 46
Median peer was paid$28K
This provider vs. median78×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official GALLEGOS, EDWARD controls 20+ related entities in our dataset. Read more
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 | 9,340 | $369K | |
| 2019 | 9,422 | $377K | |
| 2020 | 6,090 | $242K | |
| 2021 | 7,724 | $297K | |
| 2022 | 8,883 | $313K | |
| 2023 | 12,291 | $325K | |
| 2024incomplete | 10,840 | $256K |
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 | 60% | 35,615 | 33,939 | $1.31M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12% | 9,227 | 8,940 | $256K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 8.7% | 4,846 | 4,647 | $190K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 6.0% | 5,513 | 2,112 | $130K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 4.9% | 2,915 | 1,103 | $107K |
| 99223 | Prolong inpt eval add15 m | 3.6% | 1,137 | 1,111 | $78K |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.2% | 688 | 673 | $26K |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.2% | 1,053 | 1,026 | $26K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.1% | 478 | 474 | $23K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 115 | 115 | $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% | 1,576 | 1,440 | $7K |
| 99443 | <1% | 389 | 328 | $5K |
14 more codes
| 99397 | <1% | 27 | $2K | |
| 99442 | <1% | 144 | $2K | |
| 99205 | Prolong outpt/office vis | <1% | 16 | $2K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 129 | $2K |
| 96127 | <1% | 282 | $2K | |
| 99358 | Prolong nursin fac eval 15m | <1% | 35 | $1K |
| 99497 | <1% | 96 | $1K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 17 | $1K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 134 | $859.58 |
| 99417 | Prolong home eval add 15m | <1% | 12 | $576.16 |
| 99221 | <1% | 14 | $548.42 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 106 | $284.44 |
| 95251 | <1% | 12 | $274.02 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 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 officialGALLEGOS, EDWARD (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Pratt Pediatric Associates INC | Boston, MA | $7.66M |
| Pratt Ophthalmology Associates INC | Boston, MA | $2.95M |
| Pratt Ob/Gyn Associates, INC | Boston, MA | $2.62M |
| Pratt Radiology Associates, INC | Boston, MA | $1.58M |
| Pratt Pathology Associates, INC | Boston, MA | $1.47M |
| Pratt Med/Surg Dermatology Associates INC | Boston, MA | $851K |
| Cardiovascular Center at Tufts Medical Center, INC. | Boston, MA | $721K |
| Pratt Medical Group, INC | Boston, MA | $705K |
| Pratt Orthopaedic Associates, INC | Boston, MA | $566K |
| Pratt Otolaryngology- Head & Neck Surgery Associates INC | Boston, MA | $536K |
| Pratt Psychiatric Associates, INC | Boston, MA | $346K |
| Pratt Neurology Associates, INC | Boston, MA | $279K |
| Pratt Medical Group, INC | Boston, MA | $269K |
| Pratt Medical Group, INC | Boston, MA | $247K |
| Pratt Medical Group, INC | Boston, MA | $240K |
| Pratt Urology Associates, INC | Boston, MA | $204K |
| Pratt Anesthesiology Associates, INC | Boston, MA | $197K |
| Pratt Medical Group, INC | Boston, MA | $141K |
| Pratt Medical Group, INC | Boston, MA | $127K |
| Pratt Surgical Associates INC | Boston, MA | $123K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.