Physician
Pulmonary & Critical Care Associates PC
Pulmonary & Critical Care Associates PC was paid $7.30M by Medicaid between Jan 2018 and Dec 2024, across 25 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 35% of everything it billed.
33Billing provider infoPULMONARY & CRITICAL CARE ASSOCIATES PC
SHELBY TWP, MI 48315
SHELBY TWP, MI 48315
33aNPI1598700932assigned 06/19/2006
33bProvider typePulmonary Disease Physician
28Total paid$7.30M
24GClaims97,232
24DCodes billed25
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in Michigan
Rank by total paid#1 of 63
Median peer was paid$118K
This provider vs. median62×
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 | 13,137 | $909K | |
| 2019 | 11,820 | $826K | |
| 2020 | 12,402 | $969K | |
| 2021 | 15,415 | $1.17M | |
| 2022 | 14,895 | $1.10M | |
| 2023 | 15,537 | $1.19M | |
| 2024incomplete | 14,026 | $1.14M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 35% | 20,566 | 5,663 | $2.52M |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 27% | 32,506 | 9,232 | $1.98M |
| 99223 | Prolong inpt eval add15 m | 12% | 7,892 | 7,596 | $855K |
| 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 | 6.4% | 7,055 | 6,867 | $468K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 4.7% | 8,362 | 4,505 | $345K |
| 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 | 3.8% | 3,020 | 2,998 | $279K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 3.2% | 1,361 | 1,352 | $235K |
| 95811 | 1.8% | 712 | 704 | $134K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.3% | 2,098 | 2,066 | $99K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.2% | 1,193 | 1,178 | $89K |
| 94729 | <1% | 2,265 | 2,243 | $64K | |
| 94726 | <1% | 2,290 | 2,269 | $62K |
13 more codes
| 94060 | <1% | 2,115 | $50K | |
| 99205 | Prolong outpt/office vis | <1% | 176 | $19K |
| 94010 | <1% | 1,003 | $18K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 198 | $17K |
| 94618 | <1% | 889 | $17K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 252 | $15K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 1,720 | $12K |
| 99406 | <1% | 1,004 | $8K | |
| 95806 | <1% | 118 | $6K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 235 | $4K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 22 | $483.78 |
| 88738 | <1% | 101 | $291.46 | |
| 94664 | <1% | 79 | $60.65 |
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 officialHERBERT, RICHARD (PRESIDENT)