Physician
Prime Garden City Medical Group
Prime Garden City Medical Group was paid $535K by Medicaid between Jan 2018 and Oct 2023, across 36 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 15% of everything it billed.
33Billing provider infoPRIME GARDEN CITY MEDICAL GROUP
GARDEN CITY, MI 48135
GARDEN CITY, MI 48135
33aNPI1598179954assigned 06/13/2014
33bProvider typeFamily Medicine Physician
28Total paid$535K
24GClaims15,428
24DCodes billed36
24AFirst – last monthJan 2018 – Oct 2023
Compared with peers
Next to other Family Medicine Physician providers in Michigan
Rank by total paid#205 of 826
Median peer was paid$98K
This provider vs. median5.5×
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 | 8,671 | $347K | |
| 2019 | 5,145 | $164K | |
| 2020 | 1,114 | $16K | |
| 2021 | 14 | $735.00 | |
| 2022 | 255 | $7K | |
| 2023 | 229 | $1K |
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 | 15% | 1,843 | 1,756 | $78K |
| 59426 | 13% | 93 | 92 | $69K | |
| 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 | 12% | 890 | 843 | $62K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 9.4% | 68 | 66 | $50K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 7.4% | 535 | 530 | $40K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.6% | 1,255 | 1,199 | $30K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 5.2% | 348 | 348 | $28K |
| 76830 | Ultrasound, transvaginal | 5.2% | 411 | 399 | $28K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 3.9% | 346 | 342 | $21K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 3.5% | 394 | 376 | $19K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 3.4% | 341 | 320 | $18K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 3.4% | 233 | 227 | $18K |
24 more codes
| 99203 | Doctor's office visit, new patient (routine) | 2.4% | 231 | $13K |
| 59430 | 2.2% | 71 | $12K | |
| 99223 | Prolong inpt eval add15 m | 2.0% | 123 | $11K |
| 76801 | 1.2% | 95 | $7K | |
| 81025 | 1.2% | 1,015 | $6K | |
| 59025 | Fetal non-stress test | 1.1% | 208 | $6K |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,025 | $5K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 403 | $4K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 37 | $4K |
| 54150 | <1% | 39 | $2K | |
| 99254 | <1% | 14 | $1K | |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 38 | $829.33 |
| 90686 | <1% | 32 | $664.29 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 32 | $662.37 |
| 81002 | <1% | 325 | $642.40 | |
| 58300 | <1% | 15 | $583.74 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 15 | $562.71 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 32 | $211.26 |
| 3078F | <1% | 76 | $0.04 | |
| 3008F | <1% | 3,355 | $0.04 | |
| 3074F | <1% | 75 | $0.04 | |
| 1160F | 0% | 77 | $0.00 | |
| 1000F | 0% | 286 | $0.00 | |
| 99000 | 0% | 52 | $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 officialMASCIA, NICOLE (ADMIN)
Parent organizationPRIME HEALTHCARE SERVICES - GARDEN CITY, LLC