Physician
Tibrewala, Sushilkumar
Tibrewala, Sushilkumar was paid $807K by Medicaid between Jan 2018 and Oct 2024, across 11 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 58% of everything it billed.
33Billing provider infoTIBREWALA, SUSHILKUMAR
HERRIN, IL 62948
HERRIN, IL 62948
33aNPI1457366858assigned 07/31/2006
33bProvider typeGastroenterology Physician
28Total paid$807K
24GClaims6,069
24DCodes billed11
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Gastroenterology Physician providers in Illinois
Rank by total paid#10 of 370
Median peer was paid$16K
This provider vs. median50×
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 | 914 | $96K | |
| 2019 | 1,389 | $144K | |
| 2020 | 704 | $79K | |
| 2021 | 601 | $94K | |
| 2022 | 871 | $137K | |
| 2023 | 953 | $173K | |
| 2024incomplete | 637 | $83K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 58% | 2,845 | 2,588 | $468K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 23% | 943 | 888 | $186K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 6.2% | 323 | 272 | $50K |
| 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 | 3.7% | 845 | 787 | $29K |
| 99243 | 3.3% | 350 | 322 | $27K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 3.0% | 153 | 132 | $24K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 1.1% | 70 | 70 | $9K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 189 | 186 | $6K |
| 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% | 268 | 262 | $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% | 60 | 39 | $3K |
| 99442 | 0% | 23 | 12 | $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.