Heritage Medical Associates PC

Heritage Medical Associates PC was paid $5.63M by Medicaid between Jan 2018 and Dec 2024, across 68 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.

33Billing provider infoHERITAGE MEDICAL ASSOCIATES PC
NASHVILLE, TN 37203

33aNPI1548284060assigned 07/27/2006

33bProvider typePsychologist

28Total paid$5.63M

24GClaims184,262

24DCodes billed68

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Psychologist providers in Tennessee

Rank by total paid#2 of 40

Median peer was paid$21K

This provider vs. median272×

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	5,837	$212K
2019	6,726	$215K
2020	4,543	$152K
2021	48,041	$1.47M
2022	45,954	$1.38M
2023	41,538	$1.25M
2024incomplete	31,623	$942K

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	34%	48,930	43,221	$1.92M
90460	Immunization administration through 18 years of age via any route, first or only component	13%	17,700	15,778	$736K
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	9.7%	9,847	8,651	$544K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	7.6%	6,209	5,688	$430K
96110	Developmental screening, with scoring and documentation, per standardized instrument	7.5%	13,571	12,483	$422K
87636	Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B	6.6%	3,263	2,698	$371K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	5.3%	4,385	3,987	$298K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	4.0%	3,622	3,220	$223K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	1.7%	1,320	1,168	$97K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	1.6%	1,984	1,888	$92K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	1.2%	1,062	996	$70K
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	1.2%	2,437	2,303	$66K

56 more codes

95004	Percutaneous tests with allergenic extracts, immediate type reaction	1.1%	1,208	$61K
95117		<1%	4,155	$46K
92551		<1%	5,194	$41K
95165	Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials	<1%	353	$35K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	<1%	992	$28K
99173		<1%	4,368	$19K
96160		<1%	2,841	$18K
99177		<1%	3,227	$18K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	1,175	$15K
96127		<1%	2,774	$12K
42820	Tonsillectomy and adenoidectomy; younger than age 12	<1%	44	$8K
69436	Tympanostomy (requiring insertion of ventilating tube), general anesthesia	<1%	45	$7K
99238	Hospital discharge day management, 30 minutes or less	<1%	127	$6K
G0444	Annual depression screening, 5 to 15 minutes	<1%	719	$6K
80061	Lipid panel	<1%	502	$5K
85018		<1%	2,333	$5K
99460		<1%	80	$4K
36416		<1%	3,897	$4K
90686		<1%	3,646	$4K
17110		<1%	53	$3K
90670		<1%	1,584	$3K
99204	Doctor's office visit, new patient (more involved)	<1%	29	$2K
92567		<1%	197	$2K
90677		<1%	116	$1K
90698		<1%	712	$672.19
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	57	$668.23
92587		<1%	27	$641.32
83655		<1%	77	$539.55
90651		<1%	47	$538.16
0072A		<1%	13	$520.00
96161		<1%	68	$459.75
90480		<1%	12	$437.54
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	14	$415.10
90688		<1%	563	$388.27
36415	Collection of venous blood by venipuncture	<1%	345	$317.75
90680		<1%	465	$299.85
81002		<1%	183	$291.42
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	27	$246.68
90658		<1%	341	$199.19
90656		<1%	266	$174.91
90734		<1%	13	$165.61
3008F		<1%	232	$140.00
90744		<1%	149	$118.87
80076		<1%	26	$64.05
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	14	$35.66
90633		<1%	112	$33.32
99309	Subsequent nursing facility care, per day, low to moderate complexity	<1%	17	$23.52
90661		<1%	18	$0.03
90619		<1%	28	$0.03
G0270	Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes	0%	11,415	$0.00
90685		0%	28	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	28	$0.00
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	0%	14,907	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	43	$0.00
3351F		0%	13	$0.00
80053	Comprehensive metabolic panel	0%	13	$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 officialSTAUSS, CRYSTIE (PHYSICIAN SERVICES MANAGER)