Physician
Capital Health Medical Group
Capital Health Medical Group was paid $19.25M by Medicaid between Jan 2018 and Dec 2024, across 149 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 25% of everything it billed.
33Billing provider infoCAPITAL HEALTH MEDICAL GROUP
TRENTON, NJ 08638
TRENTON, NJ 08638
33aNPI1437516887assigned 01/15/2016
33bProvider typeObstetrics & Gynecology Physician
28Total paid$19.25M
24GClaims597,674
24DCodes billed149
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in New Jersey
Rank by total paid#1 of 186
Median peer was paid$75K
This provider vs. median258×
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 | 33,121 | $849K | |
| 2019 | 40,662 | $1.07M | |
| 2020 | 41,931 | $1.21M | |
| 2021 | 61,838 | $2.07M | |
| 2022 | 125,556 | $3.96M | |
| 2023 | 145,319 | $5.14M | |
| 2024incomplete | 149,247 | $4.95M |
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 | 25% | 80,134 | 73,175 | $4.80M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 16% | 70,336 | 67,646 | $3.00M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 12% | 33,568 | 32,218 | $2.26M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.7% | 34,732 | 31,685 | $1.48M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 5.3% | 34,772 | 16,559 | $1.01M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 4.5% | 10,648 | 10,089 | $875K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2.1% | 13,288 | 12,338 | $399K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.1% | 98,139 | 79,984 | $398K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 2.1% | 9,106 | 7,880 | $396K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.0% | 8,891 | 4,559 | $389K |
| 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 | 1.9% | 4,198 | 3,992 | $370K |
| 99223 | Prolong inpt eval add15 m | 1.4% | 3,300 | 3,057 | $263K |
137 more codes
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 1.4% | 2,061 | $260K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 2,730 | $181K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 4,023 | $170K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 6,284 | $159K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 5,592 | $142K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,535 | $136K |
| 95720 | <1% | 1,656 | $125K | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 5,781 | $123K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 2,255 | $122K |
| 59025 | Fetal non-stress test | <1% | 5,564 | $121K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 816 | $117K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 205 | $110K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 2,244 | $108K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 6,362 | $104K |
| 93000 | <1% | 12,617 | $101K | |
| 99254 | <1% | 824 | $101K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 1,248 | $100K |
| 88342 | <1% | 3,379 | $85K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 4,323 | $80K |
| 99460 | <1% | 1,086 | $77K | |
| 59514 | <1% | 117 | $68K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 1,010 | $55K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 288 | $52K |
| 93970 | <1% | 2,998 | $48K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,712 | $47K |
| 71045 | Radiologic examination, chest; single view | <1% | 12,995 | $47K |
| 99307 | <1% | 3,880 | $46K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 1,390 | $43K |
| 88307 | <1% | 582 | $38K | |
| 76801 | <1% | 979 | $32K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 777 | $29K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 4,237 | $26K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 606 | $24K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 1,048 | $24K |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 916 | $24K |
| 90686 | <1% | 1,992 | $23K | |
| 76818 | <1% | 526 | $22K | |
| 99462 | <1% | 673 | $22K | |
| 99443 | <1% | 273 | $19K | |
| 93971 | <1% | 1,505 | $17K | |
| 59426 | <1% | 28 | $17K | |
| 76813 | <1% | 484 | $16K | |
| 86077 | <1% | 624 | $14K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 302 | $14K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,010 | $14K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 542 | $14K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 92 | $13K |
| 99441 | <1% | 918 | $13K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 141 | $12K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 56 | $12K |
| 20610 | <1% | 465 | $11K | |
| 99205 | Prolong outpt/office vis | <1% | 209 | $11K |
| 59425 | <1% | 70 | $11K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 482 | $11K |
| 88341 | <1% | 185 | $10K | |
| 97804 | <1% | 462 | $9K | |
| 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% | 4,895 | $8K |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 177 | $8K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 87 | $7K |
| 99442 | <1% | 310 | $7K | |
| 54150 | <1% | 62 | $7K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 212 | $7K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 390 | $6K |
| 99306 | Prolong nursin fac eval 15m | <1% | 132 | $6K |
| 71250 | <1% | 217 | $5K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 4,347 | $5K |
| 76820 | <1% | 356 | $5K | |
| 93458 | <1% | 29 | $5K | |
| 99152 | <1% | 210 | $5K | |
| 93296 | <1% | 733 | $4K | |
| 93016 | <1% | 385 | $4K | |
| 93295 | <1% | 330 | $4K | |
| 93298 | <1% | 156 | $4K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 39 | $4K |
| 70551 | Magnetic resonance imaging, brain; without contrast material | <1% | 96 | $4K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,214 | $3K |
| 99385 | <1% | 31 | $3K | |
| 93018 | <1% | 386 | $3K | |
| 99217 | <1% | 82 | $3K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 92 | $3K |
| 88304 | <1% | 303 | $3K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 142 | $2K |
| 97803 | <1% | 112 | $2K | |
| 93294 | <1% | 421 | $2K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 639 | $2K |
| 95718 | <1% | 30 | $2K | |
| 77427 | <1% | 24 | $2K | |
| 82962 | <1% | 4,024 | $1K | |
| 70486 | <1% | 60 | $1K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 26 | $1K |
| 95251 | <1% | 108 | $1K | |
| 94060 | <1% | 234 | $1K | |
| 94727 | <1% | 219 | $1K | |
| 90656 | <1% | 99 | $1K | |
| 64615 | <1% | 13 | $1K | |
| 90461 | <1% | 40 | $1K | |
| 99305 | <1% | 46 | $1K | |
| 76830 | Ultrasound, transvaginal | <1% | 41 | $964.86 |
| 94729 | <1% | 220 | $953.71 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 13 | $736.04 |
| 76642 | <1% | 43 | $691.81 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 32 | $676.94 |
| 73130 | <1% | 120 | $582.69 | |
| 96127 | <1% | 201 | $554.29 | |
| 76937 | <1% | 99 | $541.95 | |
| G2066 | Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results | <1% | 25 | $503.44 |
| 73030 | <1% | 102 | $488.99 | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 30 | $463.94 |
| 95816 | <1% | 12 | $423.88 | |
| 72110 | <1% | 57 | $418.97 | |
| 81025 | <1% | 90 | $418.53 | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 12 | $371.64 |
| 73630 | <1% | 88 | $356.41 | |
| 93923 | <1% | 30 | $313.78 | |
| 73610 | <1% | 56 | $287.14 | |
| 72100 | <1% | 37 | $267.14 | |
| 36410 | <1% | 43 | $232.80 | |
| 73564 | <1% | 33 | $167.68 | |
| 90674 | <1% | 12 | $161.92 | |
| 51798 | <1% | 13 | $160.60 | |
| 94618 | <1% | 13 | $159.98 | |
| G0008 | Administration of influenza virus vaccine | <1% | 126 | $149.75 |
| 81002 | <1% | 370 | $144.67 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 12 | $132.92 |
| 73562 | <1% | 27 | $88.92 | |
| 90662 | <1% | 13 | $83.01 | |
| 77080 | <1% | 15 | $64.83 | |
| 74018 | <1% | 12 | $40.60 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 21 | $27.31 |
| 90723 | <1% | 70 | $1.00 | |
| 3288F | 0% | 30,225 | $0.00 | |
| 90670 | 0% | 90 | $0.00 | |
| 90648 | 0% | 88 | $0.00 | |
| 99173 | 0% | 15 | $0.00 | |
| 1220F | 0% | 26,355 | $0.00 | |
| 90694 | 0% | 18 | $0.00 | |
| 90647 | 0% | 16 | $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 officialFLEMING, SHANE (CHIEF FINANCIAL OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Capital Health Multispecialty Group | Trenton, NJ | $2.02M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.