Niagara Pulmonary and Sleep Medicine, P.C.
Niagara Pulmonary and Sleep Medicine, P.C. was paid $137K by Medicaid between Mar 2018 and Oct 2024, across 8 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 36% of everything it billed.
33Billing provider infoNIAGARA PULMONARY AND SLEEP MEDICINE, P.C.
NIAGARA FALLS, NY 14304
NIAGARA FALLS, NY 14304
33aNPI1336113810assigned 02/14/2006
33bProvider typeSleep Specialist (PhD)
28Total paid$137K
24GClaims3,421
24DCodes billed8
24AFirst – last monthMar 2018 – Oct 2024
Compared with peers
Next to other Sleep Specialist (PhD) providers in New York
Rank by total paid#3 of 8
Median peer was paid$12K
This provider vs. median12×
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 | 265 | $12K | |
| 2019 | 403 | $17K | |
| 2020 | 382 | $14K | |
| 2021 | 622 | $23K | |
| 2022 | 515 | $18K | |
| 2023 | 797 | $34K | |
| 2024incomplete | 437 | $19K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 36% | 959 | 957 | $50K |
| 94060 | 24% | 815 | 813 | $33K | |
| 94729 | 18% | 765 | 764 | $24K | |
| 94726 | 17% | 762 | 760 | $23K | |
| 95800 | 3.5% | 53 | 53 | $5K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.1% | 13 | 13 | $2K |
| 99442 | <1% | 13 | 13 | $598.67 | |
| 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% | 41 | 41 | $294.84 |
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 officialVENTRESCA, EDWARD (PRESIDENT)