Rocky Mountain Pulmonary & Critical

Rocky Mountain Pulmonary & Critical was paid $1.12M 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 — 88% of everything it billed.

33Billing provider infoROCKY MOUNTAIN PULMONARY & CRITICAL
WHEAT RIDGE, CO 80033

33aNPI1326162330assigned 03/16/2007

33bProvider typePulmonary Disease Physician

28Total paid$1.12M

24GClaims13,397

24DCodes billed10

24AFirst – last monthJan 2018 – Aug 2024

Compared with peers

Next to other Pulmonary Disease Physician providers in Colorado

Rank by total paid#5 of 30

Median peer was paid$72K

This provider vs. median16×

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	1,278	$82K
2019	1,022	$121K
2020	6,322	$297K
2021	2,791	$334K
2022	1,068	$144K
2023	711	$105K
2024incomplete	205	$32K

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	88%	10,073	2,434	$987K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	3.8%	1,433	450	$42K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	2.3%	1,047	356	$25K
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	1.9%	388	368	$21K
95811		1.8%	166	158	$20K
95806		1.1%	174	173	$13K
95810	Polysomnography; sleep staging with 4 or more additional parameters	<1%	57	53	$6K
94060		<1%	32	31	$966.14
94729		<1%	14	13	$438.70
94726		<1%	13	12	$397.08

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 officialSCHAIRER, DENISE (ADMINISTRATIVE ASSISTANT)