Verma, Ajay

Verma, Ajay was paid $61K by Medicaid between Jan 2018 and Aug 2024, across 10 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 46% of everything it billed.

33Billing provider infoVERMA, AJAY
DECATUR, IL 62526

33aNPI1285609321assigned 02/22/2006

33bProvider typePulmonary Disease Physician

28Total paid$61K

24GClaims1,978

24DCodes billed10

24AFirst – last monthJan 2018 – Aug 2024

Compared with peers

Next to other Pulmonary Disease Physician providers in Illinois

Rank by total paid#100 of 212

Median peer was paid$51K

This provider vs. median1.2×

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	470	$6K
2019	315	$6K
2020	283	$6K
2021	453	$26K
2022	140	$5K
2023	105	$8K
2024incomplete	212	$3K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	46%	214	85	$28K
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	34%	737	690	$21K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	13%	355	185	$8K
94726		1.7%	178	168	$1K
94618		1.5%	90	87	$899.27
94010		1.3%	152	139	$786.16
94729		1.2%	171	160	$698.78
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	1.1%	55	38	$687.98
95811		<1%	13	12	$326.76
94060		<1%	13	13	$150.51

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.