Musial, Sandra

Musial, Sandra was paid $243K by Medicaid between Jan 2018 and Jun 2021, across 18 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 39% of everything it billed.

33Billing provider infoMUSIAL, SANDRA
PROVIDENCE, RI 02903

33aNPI1477589653assigned 06/23/2006

33bProvider typePediatrics Physician

28Total paid$243K

24GClaims3,338

24DCodes billed18

24AFirst – last monthJan 2018 – Jun 2021

Compared with peers

Next to other Pediatrics Physician providers in Rhode Island

Rank by total paid#83 of 265

Median peer was paid$133K

This provider vs. median1.8×

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	1,330	$90K
2019	236	$12K
2020	1,091	$85K
2021	681	$57K

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	39%	1,179	1,123	$94K
90460	Immunization administration through 18 years of age via any route, first or only component	21%	770	744	$50K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	9.0%	182	172	$22K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	9.0%	190	168	$22K
90461		7.0%	335	318	$17K
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	5.4%	109	99	$13K
96110	Developmental screening, with scoring and documentation, per standardized instrument	3.4%	69	68	$8K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.3%	43	43	$6K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	1.2%	27	27	$3K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	1.1%	85	85	$3K
87491	Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe	<1%	12	12	$1K
87591	Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe	<1%	12	12	$1K

6 more codes

82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	<1%	17	$1K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2	<1%	27	$832.50
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	14	$665.98
83036	Hemoglobin; glycosylated (A1C)	<1%	16	$315.19
36415	Collection of venous blood by venipuncture	<1%	13	$191.71
90686		<1%	238	$119.00

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.