Madison Medical Affiliates, INC.

Madison Medical Affiliates, INC. was paid $1.11M by Medicaid between Jan 2018 and Dec 2024, across 57 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 31% of everything it billed.

33Billing provider infoMADISON MEDICAL AFFILIATES, INC.
MILWAUKEE, WI 53202

33aNPI1588695746assigned 07/06/2006

33bProvider typeGeneral Practice Physician

28Total paid$1.11M

24GClaims40,390

24DCodes billed57

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other General Practice Physician providers in Wisconsin

Rank by total paid#5 of 20

Median peer was paid$18K

This provider vs. median63×

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	7,209	$174K
2019	5,985	$146K
2020	4,933	$125K
2021	7,059	$180K
2022	5,988	$177K
2023	5,973	$176K
2024incomplete	3,243	$137K

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	31%	10,974	9,943	$343K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	16%	7,589	6,995	$177K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	14%	1,026	953	$159K
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	7.2%	1,192	1,084	$81K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	5.1%	210	185	$57K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	2.6%	689	621	$29K
45380	Colonoscopy, flexible; with biopsy, single or multiple	2.1%	104	97	$23K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	1.9%	774	734	$22K
88305	Level IV - Surgical pathology, gross and microscopic examination	1.6%	346	296	$18K
93970		1.5%	952	869	$17K
94010		1.4%	537	474	$16K
92015	Determination of refractive state	1.3%	2,332	2,116	$15K

45 more codes

92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	1.3%	413	$15K
99231	Subsequent hospital care, per day, straightforward or low complexity	1.2%	1,068	$13K
84443	Thyroid stimulating hormone (TSH)	1.2%	837	$13K
99203	Doctor's office visit, new patient (routine)	1.1%	277	$12K
83036	Hemoglobin; glycosylated (A1C)	1.0%	1,927	$11K
99205	Prolong outpt/office vis	<1%	101	$9K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	<1%	310	$8K
93971		<1%	520	$7K
99222	Initial hospital care, per day, moderate complexity	<1%	180	$7K
99233	Hospital visit by a doctor, follow-up day (complex)	<1%	355	$7K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	405	$7K
95004	Percutaneous tests with allergenic extracts, immediate type reaction	<1%	85	$6K
84439		<1%	639	$5K
94618		<1%	350	$4K
82962		<1%	2,148	$4K
76816	Ultrasound, pregnant uterus, real time with image documentation, follow-up	<1%	52	$3K
45378	Colonoscopy, flexible; diagnostic, including collection of specimen(s)	<1%	12	$3K
99232	Hospital visit by a doctor, follow-up day	<1%	157	$2K
0012A		<1%	63	$2K
0011A		<1%	71	$2K
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	<1%	25	$2K
17110		<1%	70	$2K
99443		<1%	95	$1K
76801		<1%	14	$1K
97530	Therapeutic activities, direct patient contact, each 15 minutes	<1%	53	$1K
88175	Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer	<1%	65	$1K
94726		<1%	160	$994.71
94729		<1%	189	$791.68
94060		<1%	92	$715.18
36416		<1%	1,326	$643.33
80053	Comprehensive metabolic panel	<1%	72	$621.47
95806		<1%	12	$531.50
92250		<1%	32	$497.01
87491	Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe	<1%	12	$379.87
87591	Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe	<1%	12	$365.97
87661	Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe	<1%	13	$363.17
81000		<1%	163	$295.72
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)	<1%	99	$262.13
99152		<1%	15	$261.69
80048	Basic metabolic panel (calcium, ionized)	<1%	29	$221.05
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	39	$157.16
36415	Collection of venous blood by venipuncture	<1%	893	$150.51
51798		<1%	17	$89.82
91301		<1%	150	$0.34
99308	Subsequent nursing facility care, per day, straightforward	0%	48	$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 officialBUTZEN, KAAREN (CREDENTIALING)