Physician
Prophylaxis Healthcare LLC
Prophylaxis Healthcare LLC was paid $12.21M by Medicaid between Jan 2018 and Dec 2024, across 111 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 45% of everything it billed.
33Billing provider infoPROPHYLAXIS HEALTHCARE LLC
BIXBY, OK 74008
BIXBY, OK 74008
33aNPI1538453923assigned 06/03/2011
33bProvider typePain Medicine (Anesthesiology) Physician
28Total paid$12.21M
24GClaims229,876
24DCodes billed111
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pain Medicine (Anesthesiology) Physician providers in Oklahoma
Rank by total paid#1 of 19
Median peer was paid$368K
This provider vs. median33×
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 | 19,412 | $788K | |
| 2019 | 26,541 | $876K | |
| 2020 | 16,838 | $916K | |
| 2021 | 34,366 | $1.69M | |
| 2022 | 48,296 | $2.48M | |
| 2023 | 46,514 | $2.91M | |
| 2024incomplete | 37,909 | $2.55M |
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 | 45% | 60,180 | 55,110 | $5.51M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 24% | 46,067 | 42,783 | $2.95M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 8.5% | 18,947 | 17,948 | $1.04M |
| 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 | 4.5% | 7,556 | 7,075 | $555K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.1% | 6,517 | 6,254 | $260K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 1.8% | 2,127 | 2,112 | $216K |
| 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 | 1.5% | 1,281 | 1,280 | $179K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.4% | 1,898 | 1,896 | $174K |
| 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 | 1.4% | 6,962 | 6,508 | $165K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.3% | 7,968 | 4,634 | $157K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 6,095 | 5,797 | $120K |
| 80050 | General health panel | <1% | 2,644 | 2,638 | $82K |
99 more codes
| 36415 | Collection of venous blood by venipuncture | <1% | 11,227 | $44K |
| 80061 | Lipid panel | <1% | 3,699 | $44K |
| 96127 | <1% | 8,594 | $43K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 925 | $42K |
| 80053 | Comprehensive metabolic panel | <1% | 3,817 | $36K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 197 | $31K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 468 | $30K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 3,630 | $25K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,506 | $22K |
| 99406 | <1% | 1,605 | $22K | |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | <1% | 93 | $20K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 213 | $20K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,122 | $20K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 182 | $19K |
| 99442 | <1% | 262 | $19K | |
| 82670 | <1% | 739 | $18K | |
| 96367 | <1% | 834 | $17K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 589 | $17K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 149 | $16K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 148 | $13K |
| 84410 | <1% | 276 | $13K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 256 | $12K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | <1% | 82 | $11K |
| 84439 | <1% | 1,294 | $10K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 685 | $10K |
| 84153 | <1% | 595 | $10K | |
| 99490 | Ccm add 20min | <1% | 1,451 | $10K |
| 84403 | <1% | 411 | $10K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 91 | $9K |
| 84270 | <1% | 442 | $9K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 96 | $8K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 269 | $8K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 568 | $8K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 313 | $8K |
| 99443 | <1% | 78 | $8K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 394 | $7K |
| J1071 | Injection, testosterone cypionate, 1 mg | <1% | 3,027 | $7K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 71 | $6K |
| 87653 | <1% | 165 | $6K | |
| 87641 | <1% | 162 | $6K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 159 | $5K |
| 96368 | <1% | 341 | $5K | |
| 82627 | <1% | 223 | $4K | |
| 83001 | <1% | 262 | $4K | |
| 87481 | <1% | 128 | $4K | |
| 82728 | <1% | 314 | $4K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 121 | $4K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 102 | $4K |
| 87640 | <1% | 99 | $4K | |
| 87500 | <1% | 98 | $3K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 109 | $3K |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 109 | $3K |
| 87511 | <1% | 109 | $3K | |
| 84146 | <1% | 196 | $3K | |
| 99439 | <1% | 478 | $3K | |
| 99441 | <1% | 67 | $3K | |
| 87581 | <1% | 85 | $3K | |
| 87541 | <1% | 85 | $3K | |
| 87556 | <1% | 81 | $3K | |
| 87561 | <1% | 81 | $3K | |
| 87529 | <1% | 44 | $3K | |
| 87486 | <1% | 73 | $3K | |
| 84480 | <1% | 202 | $3K | |
| 93922 | <1% | 48 | $2K | |
| J3475 | Injection, magnesium sulfate, per 500 mg | <1% | 919 | $2K |
| 84144 | <1% | 109 | $2K | |
| 82533 | <1% | 112 | $2K | |
| 99385 | <1% | 14 | $2K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 459 | $2K |
| 84402 | <1% | 64 | $1K | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 592 | $1K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 84 | $1K |
| 95927 | <1% | 19 | $1K | |
| 83002 | <1% | 56 | $954.60 | |
| 82607 | <1% | 72 | $949.69 | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 26 | $793.37 |
| 81025 | <1% | 81 | $618.06 | |
| G2058 | Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)). | <1% | 104 | $529.04 |
| 87274 | <1% | 48 | $511.68 | |
| 87273 | <1% | 48 | $511.68 | |
| 99051 | <1% | 76 | $499.24 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 603 | $494.96 |
| 84481 | <1% | 28 | $421.96 | |
| 84436 | <1% | 60 | $371.59 | |
| 87503 | <1% | 12 | $297.00 | |
| 99173 | <1% | 111 | $280.34 | |
| J7042 | 5% dextrose/normal saline (500 ml = 1 unit) | <1% | 131 | $140.11 |
| 93000 | <1% | 12 | $127.46 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 45 | $125.96 |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 13 | $116.63 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 14 | $86.79 |
| 96160 | <1% | 1,864 | $80.59 | |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | <1% | 13 | $63.15 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 233 | $51.60 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 146 | $46.67 |
| 90715 | 0% | 17 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 45 | $0.00 |
| 90651 | 0% | 15 | $0.00 | |
| 90686 | 0% | 50 | $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 officialSANCHEZ, BERT (CEO)