Gaps Health Or PC

Gaps Health Or PC was paid $213K by Medicaid between Mar 2020 and Aug 2023, across 12 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 36% of everything it billed.

33Billing provider infoGAPS HEALTH OR PC
SALEM, OR 97301

33aNPI1285279042assigned 11/15/2019

33bProvider typeInternal Medicine Physician

28Total paid$213K

24GClaims31,056

24DCodes billed12

24AFirst – last monthMar 2020 – Aug 2023

Compared with peers

Next to other Internal Medicine Physician providers in Oregon

Rank by total paid#24 of 96

Median peer was paid$14K

This provider vs. median15×

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
2020	6,605	$40K
2021	14,442	$79K
2022	8,208	$68K
2023	1,801	$26K

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	36%	9,968	5,054	$78K
99308	Subsequent nursing facility care, per day, straightforward	33%	12,261	5,868	$71K
99306	Prolong nursin fac eval 15m	10%	1,176	793	$22K
99305		7.3%	950	652	$16K
99310	Prolong nursin fac eval 15m	5.8%	1,118	653	$12K
99490	Ccm add 20min	2.9%	3,585	1,959	$6K
99497		2.2%	585	404	$5K
99307		<1%	364	171	$1K
G0506	Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	<1%	774	375	$640.90
G0180	Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	<1%	175	117	$451.56
99316		<1%	32	29	$398.12
99318		<1%	68	45	$393.39

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 officialKOSARAJU, NITISH (PHYSICIAN)