Physician
Congenial Healthcare, LLC
Congenial Healthcare, LLC was paid $704K by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 61% of everything it billed.
33Billing provider infoCONGENIAL HEALTHCARE, LLC
LYNN, MA 01901
LYNN, MA 01901
33aNPI1558872895assigned 10/13/2017
33bProvider typeFamily Medicine Physician
28Total paid$704K
24GClaims20,862
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Massachusetts
Rank by total paid#35 of 744
Median peer was paid$10K
This provider vs. median67×
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 | 3,640 | $90K | |
| 2019 | 4,677 | $130K | |
| 2020 | 2,976 | $133K | |
| 2021 | 2,916 | $147K | |
| 2022 | 2,882 | $153K | |
| 2023 | 2,086 | $32K | |
| 2024incomplete | 1,685 | $18K |
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 | 61% | 9,857 | 8,926 | $427K |
| 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 | 25% | 3,388 | 3,319 | $173K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 4.4% | 378 | 375 | $31K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.9% | 833 | 825 | $13K |
| 90756 | 1.8% | 706 | 693 | $12K | |
| 99493 | 1.3% | 189 | 186 | $9K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.3% | 118 | 118 | $9K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 972 | 952 | $5K |
| 90686 | <1% | 276 | 275 | $4K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 126 | 125 | $3K |
| ATP17 | <1% | 460 | 460 | $3K | |
| ATP14 | <1% | 194 | 193 | $2K |
16 more codes
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 281 | $2K |
| 80053 | Comprehensive metabolic panel | <1% | 1,037 | $1K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 102 | $1K |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans | <1% | 40 | $1K |
| 80061 | Lipid panel | <1% | 910 | $1K |
| 90661 | <1% | 69 | $1K | |
| G0008 | Administration of influenza virus vaccine | <1% | 324 | $774.50 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 42 | $736.20 |
| 99442 | <1% | 44 | $639.12 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 25 | $561.86 |
| 93000 | <1% | 42 | $434.62 | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 290 | $391.57 |
| 82043 | <1% | 93 | $279.76 | |
| 82728 | <1% | 15 | $168.60 | |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | <1% | 12 | $114.48 |
| 90674 | 0% | 39 | $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 officialDOUGLAS, DAVID (PHYSICIAN)
Parent organizationCONGENIAL HEALTHCARE, LLC
| Provider | Location | Paid |
|---|---|---|
| We Care Adult Services, INC. | Upper Marlboro, MD | $9.25M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.