Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PRATT PEDIATRIC ASSOCIATES INC

NPI: 1477590511 · BOSTON, MA 02111 · Clinical Genetics (M.D.) Physician · NPI assigned 05/31/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official GALLEGOS, EDWARD controls 20+ related entities in our dataset. Read more

$7.66M
Total Medicaid Paid
150,464
Total Claims
142,411
Beneficiaries
72
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGALLEGOS, EDWARD (DIRECTOR)
NPI Enumeration Date05/31/2006

Related Entities

Other providers sharing the same authorized official: GALLEGOS, EDWARD

ProviderCityStateTotal Paid
PRATT OPHTHALMOLOGY ASSOCIATES INC BOSTON MA $2.95M
PRATT OB/GYN ASSOCIATES, INC BOSTON MA $2.62M
PRATT MEDICAL GROUP, INC BOSTON MA $2.18M
PRATT RADIOLOGY ASSOCIATES, INC BOSTON MA $1.58M
PRATT PATHOLOGY ASSOCIATES, INC BOSTON MA $1.47M
PRATT MED/SURG DERMATOLOGY ASSOCIATES INC BOSTON MA $851K
CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER, INC. BOSTON MA $721K
PRATT MEDICAL GROUP, INC BOSTON MA $705K
PRATT ORTHOPAEDIC ASSOCIATES, INC BOSTON MA $566K
PRATT OTOLARYNGOLOGY- HEAD & NECK SURGERY ASSOCIATES INC BOSTON MA $536K
PRATT PSYCHIATRIC ASSOCIATES, INC BOSTON MA $346K
PRATT NEUROLOGY ASSOCIATES, INC BOSTON MA $279K
PRATT MEDICAL GROUP, INC BOSTON MA $269K
PRATT MEDICAL GROUP, INC BOSTON MA $247K
PRATT MEDICAL GROUP, INC BOSTON MA $240K
PRATT UROLOGY ASSOCIATES, INC BOSTON MA $204K
PRATT ANESTHESIOLOGY ASSOCIATES, INC BOSTON MA $197K
PRATT MEDICAL GROUP, INC BOSTON MA $141K
PRATT MEDICAL GROUP, INC BOSTON MA $127K
PRATT SURGICAL ASSOCIATES INC BOSTON MA $123K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 18,572 $944K
2019 21,966 $1.18M
2020 23,580 $1.15M
2021 30,089 $1.55M
2022 17,002 $1.03M
2023 19,935 $936K
2024 19,320 $871K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 22,089 21,593 $1.50M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 27,155 25,739 $1.17M
99215 Prolong outpt/office vis 12,333 11,914 $1.14M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 6,292 6,281 $711K
99479 Subsequent intensive care, per day, very low birth weight infant 2,959 1,216 $282K
99239 Hospital discharge day management, more than 30 minutes 3,278 3,255 $270K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,726 4,724 $268K
99205 Prolong outpt/office vis 1,771 1,771 $250K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3,219 3,215 $208K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 2,276 1,961 $191K
96110 Developmental screening, with scoring and documentation, per standardized instrument 18,117 17,893 $187K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 2,973 2,840 $175K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 2,251 1,979 $165K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,548 2,545 $160K
99460 1,528 1,518 $152K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger 457 169 $135K
99480 Subsequent intensive care, per day, low birth weight infant 989 452 $93K
99462 1,897 1,593 $83K
93000 4,465 4,367 $57K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 7,063 6,726 $40K
76825 636 611 $39K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 549 546 $37K
99417 Prolong home eval add 15m 1,200 1,172 $32K
93320 1,553 1,333 $31K
96127 2,726 2,661 $25K
90791 Psychiatric diagnostic evaluation 198 198 $22K
93325 3,609 3,083 $21K
99307 886 884 $20K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 440 414 $19K
99232 Subsequent hospital care, per day, moderate complexity 338 152 $18K
T2023 Targeted case management; per month 75 75 $18K
99233 Prolong inpt eval add15 m 204 87 $15K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 304 304 $14K
76827 639 612 $14K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 147 146 $13K
99238 Hospital discharge day management, 30 minutes or less 198 195 $11K
92551 767 762 $7K
99222 Initial hospital care, per day, moderate complexity 65 65 $7K
90460 Immunization administration through 18 years of age via any route, first or only component 2,629 2,614 $7K
99173 645 645 $6K
99051 414 409 $6K
99231 Subsequent hospital care, per day, straightforward or low complexity 162 69 $5K
99464 83 83 $5K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 159 154 $4K
99309 Subsequent nursing facility care, per day, low to moderate complexity 72 71 $4K
94010 203 177 $3K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 320 316 $3K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 208 203 $2K
90461 790 789 $2K
99223 Prolong inpt eval add15 m 15 15 $2K
95816 42 41 $2K
94016 152 152 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 368 368 $1K
93304 31 25 $1K
99443 37 35 $1K
99221 12 12 $934.80
99310 Prolong nursin fac eval 15m 12 12 $839.20
99188 26 26 $700.96
96112 13 13 $627.98
94664 44 44 $603.96
90472 Immunization administration, each additional vaccine (list separately) 138 138 $597.25
81002 105 103 $281.70
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) 38 38 $273.57
99442 14 14 $216.97
99050 12 12 $174.56
93321 15 12 $151.30
85018 58 58 $58.14
90686 47 47 $56.38
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) 570 563 $56.04
96161 12 12 $6.42
94760 47 39 $1.98
99001 51 51 $0.00