Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PRATT MEDICAL GROUP, INC

NPI: 1275570319 · BOSTON, MA 02111 · Nephrology Physician · NPI assigned 05/31/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official GALLEGOS, EDWARD controls 20+ related entities in our dataset. Read more

$2.18M
Total Medicaid Paid
64,590
Total Claims
56,807
Beneficiaries
26
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGALLEGOS, EDWARD (DIRECTOR)
NPI Enumeration Date05/31/2006

Related Entities

Other providers sharing the same authorized official: GALLEGOS, EDWARD

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 10,840 $256K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 35,615 33,939 $1.31M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,227 8,940 $256K
99215 Prolong outpt/office vis 4,846 4,647 $190K
99232 Subsequent hospital care, per day, moderate complexity 5,513 2,112 $130K
99233 Prolong inpt eval add15 m 2,915 1,103 $107K
99223 Prolong inpt eval add15 m 1,137 1,111 $78K
99239 Hospital discharge day management, more than 30 minutes 688 673 $26K
99238 Hospital discharge day management, 30 minutes or less 1,053 1,026 $26K
99222 Initial hospital care, per day, moderate complexity 478 474 $23K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 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) 1,576 1,440 $7K
99443 389 328 $5K
99397 27 26 $2K
99442 144 131 $2K
99205 Prolong outpt/office vis 16 16 $2K
99231 Subsequent hospital care, per day, straightforward or low complexity 129 59 $2K
96127 282 253 $2K
99358 Prolong nursin fac eval 15m 35 34 $1K
99497 96 92 $1K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 17 17 $1K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 134 117 $859.58
99417 Prolong home eval add 15m 12 12 $576.16
99221 14 14 $548.42
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 106 102 $284.44
95251 12 12 $274.02
G8510 Screening for depression is documented as negative, a follow-up plan is not required 14 14 $0.00