Rheumatology and Pulmonary Clinic PLLC
Rheumatology and Pulmonary Clinic PLLC was paid $631K by Medicaid between Jan 2018 and Dec 2024, across 47 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 28% of everything it billed.
33Billing provider infoRHEUMATOLOGY AND PULMONARY CLINIC PLLC
BECKLEY, WV 25801
BECKLEY, WV 25801
33aNPI1467439463assigned 12/30/2005
33bProvider typeSpecialist
28Total paid$631K
24GClaims31,314
24DCodes billed47
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in West Virginia
Rank by total paid#20 of 71
Median peer was paid$232K
This provider vs. median2.7×
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 | 13,764 | $206K | |
| 2019 | 1,885 | $57K | |
| 2020 | 3,414 | $81K | |
| 2021 | 2,965 | $64K | |
| 2022 | 2,103 | $59K | |
| 2023 | 3,740 | $90K | |
| 2024incomplete | 3,443 | $74K |
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 | 28% | 6,975 | 6,259 | $174K |
| 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 | 26% | 4,449 | 3,519 | $165K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 12% | 2,133 | 732 | $75K |
| 94726 | 2.8% | 1,328 | 1,186 | $18K | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 2.7% | 1,458 | 1,374 | $17K |
| 94729 | 2.7% | 1,334 | 1,184 | $17K | |
| 94060 | 2.5% | 1,318 | 1,179 | $16K | |
| 71046 | Radiologic examination, chest; 2 views | 2.1% | 1,511 | 1,256 | $13K |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 1.9% | 928 | 880 | $12K |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 1.6% | 843 | 805 | $10K |
| 20610 | 1.5% | 218 | 158 | $9K | |
| 1006F | 1.2% | 570 | 544 | $8K |
35 more codes
| G9716 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason | <1% | 410 | $6K |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | <1% | 507 | $6K |
| 4004F | <1% | 552 | $5K | |
| G8783 | Normal blood pressure reading documented, follow-up not required | <1% | 540 | $5K |
| G8752 | Most recent systolic blood pressure < 140 mmhg | <1% | 547 | $5K |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | <1% | 551 | $5K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 130 | $5K |
| 1170F | <1% | 370 | $5K | |
| G8731 | Pain assessment using a standardized tool is documented as negative, no follow-up plan required | <1% | 353 | $4K |
| 3023F | <1% | 456 | $4K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 68 | $4K |
| 1036F | <1% | 370 | $4K | |
| 99442 | <1% | 388 | $3K | |
| 4040F | <1% | 422 | $3K | |
| G8482 | Influenza immunization administered or previously received | <1% | 408 | $3K |
| 3455F | <1% | 251 | $3K | |
| 4192F | <1% | 215 | $3K | |
| G9695 | Long-acting inhaled bronchodilator prescribed | <1% | 333 | $3K |
| 3475F | <1% | 253 | $2K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 54 | $2K |
| 95811 | <1% | 63 | $2K | |
| 3470F | <1% | 196 | $2K | |
| 99441 | <1% | 258 | $1K | |
| 99223 | Prolong inpt eval add15 m | <1% | 31 | $1K |
| 3476F | <1% | 62 | $1K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 31 | $1K |
| 4193F | <1% | 92 | $1K | |
| 3471F | <1% | 59 | $1K | |
| G8399 | Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed | <1% | 127 | $1K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 27 | $1K |
| 99221 | <1% | 15 | $1K | |
| 0540F | <1% | 60 | $828.42 | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 21 | $750.60 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 13 | $275.00 |
| 77080 | 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 officialFONDALE, BECKY (OFFICE MANAGER)