Herzlinger, Michael

Herzlinger, Michael was paid $26K by Medicaid between Apr 2018 and Jan 2023, across 3 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 69% of everything it billed.

33Billing provider infoHERZLINGER, MICHAEL
PROVIDENCE, RI 02903

33aNPI1275795726assigned 06/26/2008

33bProvider typePediatric Gastroenterology Physician

28Total paid$26K

24GClaims130

24DCodes billed3

24AFirst – last monthApr 2018 – Jan 2023

Compared with peers

Next to other Pediatric Gastroenterology Physician providers in Rhode Island

Rank by total paid#1 of 8

Median peer was paid$12K

This provider vs. median2.2×

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	25	$2K
2019	12	$943.44
2021	39	$7K
2022	42	$10K
2023	12	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	69%	40	40	$18K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	20%	53	27	$5K
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	11%	37	37	$3K

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.