Physician
Prohealth Medical Group INC.
Prohealth Medical Group INC. was paid $8.25M by Medicaid between Jan 2018 and Dec 2024, across 106 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 32% of everything it billed.
33Billing provider infoPROHEALTH MEDICAL GROUP INC.
WAUKESHA, WI 53188
WAUKESHA, WI 53188
33aNPI1356322440assigned 11/07/2005
33bProvider typeAllergy & Immunology Physician
28Total paid$8.25M
24GClaims412,072
24DCodes billed106
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Allergy & Immunology Physician providers in Wisconsin
Rank by total paid#3 of 11
Median peer was paid$26K
This provider vs. median313×
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 | 44,780 | $925K | |
| 2019 | 54,608 | $1.12M | |
| 2020 | 52,782 | $911K | |
| 2021 | 74,809 | $1.37M | |
| 2022 | 74,513 | $1.37M | |
| 2023 | 65,079 | $1.32M | |
| 2024incomplete | 45,501 | $1.24M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 32% | 77,803 | 68,674 | $2.68M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 81,803 | 73,328 | $2.15M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 6.7% | 17,180 | 11,353 | $549K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 5.3% | 11,829 | 4,073 | $440K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 5.2% | 14,352 | 5,567 | $425K |
| 99000 | 2.9% | 70,773 | 61,061 | $239K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.2% | 4,873 | 4,238 | $183K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.0% | 28,207 | 23,032 | $168K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 1.6% | 2,785 | 1,626 | $129K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.5% | 4,486 | 3,863 | $121K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.4% | 1,446 | 1,242 | $112K |
| 76819 | Fetal biophysical profile; without non-stress testing | 1.3% | 3,930 | 1,620 | $111K |
94 more codes
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 1.2% | 4,236 | $99K |
| 99215 | Doctor's office visit, returning patient (complex) | 1.0% | 2,011 | $84K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 2,867 | $76K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 819 | $53K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 3,906 | $50K |
| 90686 | <1% | 6,137 | $46K | |
| 80305 | <1% | 5,590 | $42K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 766 | $41K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 1,392 | $41K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 3,783 | $37K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 2,371 | $33K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,193 | $28K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 411 | $24K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 607 | $19K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 340 | $18K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,637 | $17K |
| 11721 | <1% | 1,403 | $16K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 348 | $14K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 476 | $14K |
| 36415 | Collection of venous blood by venipuncture | <1% | 36,623 | $14K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 175 | $12K |
| 0001A | <1% | 339 | $11K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 204 | $11K |
| 0002A | <1% | 307 | $11K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 571 | $10K |
| 90839 | <1% | 171 | $10K | |
| 97535 | Self-care/home management training, each 15 minutes | <1% | 770 | $10K |
| 99442 | <1% | 628 | $8K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 140 | $8K |
| 0011A | <1% | 184 | $6K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 335 | $6K |
| 0012A | <1% | 173 | $6K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 198 | $5K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 194 | $5K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 78 | $4K |
| 0071A | <1% | 166 | $4K | |
| 0072A | <1% | 144 | $4K | |
| 99242 | <1% | 86 | $3K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 98 | $3K |
| 99223 | Prolong inpt eval add15 m | <1% | 102 | $3K |
| 0064A | <1% | 93 | $3K | |
| 76801 | <1% | 55 | $2K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 57 | $2K |
| 90656 | <1% | 126 | $2K | |
| 0004A | <1% | 70 | $2K | |
| 76813 | <1% | 53 | $2K | |
| 99243 | <1% | 30 | $2K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 16 | $2K |
| 64615 | <1% | 12 | $2K | |
| 0054A | <1% | 52 | $1K | |
| 76820 | <1% | 61 | $1K | |
| 0031A | <1% | 48 | $1K | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 18 | $1K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 37 | $1K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 2,862 | $934.02 |
| 96139 | <1% | 13 | $900.32 | |
| 98968 | <1% | 59 | $845.47 | |
| 92504 | <1% | 61 | $830.88 | |
| 99205 | Prolong outpt/office vis | <1% | 13 | $768.60 |
| 73630 | <1% | 45 | $701.35 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 16 | $590.10 |
| 95886 | <1% | 12 | $579.83 | |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 42 | $559.48 |
| 0052A | <1% | 30 | $534.24 | |
| 95251 | <1% | 57 | $468.25 | |
| 99441 | <1% | 68 | $467.97 | |
| 99443 | <1% | 16 | $435.08 | |
| 17110 | <1% | 26 | $383.40 | |
| 90670 | <1% | 60 | $338.98 | |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | <1% | 12 | $324.87 |
| 93793 | <1% | 62 | $247.71 | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 30 | $206.20 |
| 98967 | <1% | 16 | $182.75 | |
| 90698 | <1% | 12 | $180.00 | |
| 90633 | <1% | 63 | $178.84 | |
| 74018 | <1% | 13 | $173.69 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,103 | $170.01 |
| 96138 | <1% | 13 | $149.57 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 13 | $135.72 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 16 | $93.83 |
| 95117 | <1% | 21 | $74.25 | |
| 90672 | <1% | 19 | $60.18 | |
| 90685 | <1% | 15 | $49.65 | |
| 90651 | <1% | 13 | $39.72 | |
| 81003 | <1% | 14 | $10.66 | |
| 91300 | <1% | 868 | $1.96 | |
| 91301 | <1% | 395 | $0.82 | |
| 91307 | <1% | 313 | $0.22 | |
| 91305 | <1% | 132 | $0.10 | |
| 91306 | <1% | 93 | $0.04 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 49 | $0.00 |
| 90461 | 0% | 174 | $0.00 | |
| 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) | 0% | 12 | $0.00 |
| 91303 | 0% | 47 | $0.00 |
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 officialJOHNSON, THOMAS (REIMBURSEMENT MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Lakeview Behavioral Health INC. | Grand Rapids, MN | $15.98M |
| Crossroads Support Services, INC | Goldsboro, NC | $13.54M |
| Hometown Recovery and Counseling LLC | Ironton, OH | $6.60M |
| New England Allergy,asthma,immunology and Primary Care P.C. | North Andover, MA | $2.01M |
| Thomas N Johnson Optometric Corp | Sauk Rapids, MN | $653K |
| Waukesha Health System, INC | Waukesha, WI | $283K |
| Prohealth Home Care INC | Waukesha, WI | $256K |
| Urban Life Counseling Center, INC. | East Orange, NJ | $255K |
| DR Thomas D Johnson PLLC | Mt Washington, KY | $77K |
| GMN Associates | Richardson, TX | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.