Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › CO › Denver › NPI 1396354866
Physician

Poudre Valley Medical Group, LLC

Poudre Valley Medical Group, LLC was paid $231K by Medicaid between Mar 2021 and Oct 2024, across 10 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 50% of everything it billed.

33Billing provider infoPOUDRE VALLEY MEDICAL GROUP, LLC
DENVER, CO 80206
33aNPI1396354866assigned 07/30/2020
33bProvider typeRheumatology Physician
28Total paid$231K
24GClaims3,364
24DCodes billed10
24AFirst – last monthMar 2021 – Oct 2024
Compared with peers

Next to other Rheumatology Physician providers in Colorado

Rank by total paid#5 of 31
Median peer was paid$7K
This provider vs. median34×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official CONROY, JANA controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$10K$20K2018201920202021202220232024
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
YearClaimsPaid
2021311$26K
20221,595$111K
20231,261$87K
2024incomplete197$8K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 50% 1,289 1,064 $115K
99205 Prolong outpt/office vis 24% 488 366 $56K
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 14% 614 593 $32K
99417 Prolong home eval add 15m 8.5% 366 312 $20K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1.3% 75 70 $3K
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 1.2% 28 28 $3K
76881 <1% 25 16 $2K
83036 Hemoglobin; glycosylated (A1C) <1% 99 93 $407.97
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% 366 330 $279.07
95251 <1% 14 12 $170.76

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 officialCONROY, JANA (DIRECTOR OF CREDENTIALING)
Parent organizationPOUDRE VALLEY MEDICAL GROUP, LLC
Same official

Other billing entities under CONROY, JANA

Full network →

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.