Pensacola Lung Group, M.D.'S, P.A.
Pensacola Lung Group, M.D.'S, P.A. was paid $957K by Medicaid between Jan 2018 and Nov 2024, across 11 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 65% of everything it billed.
33Billing provider infoPENSACOLA LUNG GROUP, M.D.'S, P.A.
PENSACOLA, FL 32503
PENSACOLA, FL 32503
33aNPI1619196151assigned 04/24/2007
33bProvider typeSpecialist
28Total paid$957K
24GClaims25,168
24DCodes billed11
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Specialist providers in Florida
Rank by total paid#61 of 553
Median peer was paid$31K
This provider vs. median31×
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 | 1,426 | $39K | |
| 2019 | 2,514 | $66K | |
| 2020 | 3,641 | $134K | |
| 2021 | 5,233 | $231K | |
| 2022 | 4,827 | $176K | |
| 2023 | 6,007 | $269K | |
| 2024incomplete | 1,520 | $42K |
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 | 65% | 10,245 | 3,331 | $619K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 34% | 14,003 | 4,603 | $322K |
| 99223 | Prolong inpt eval add15 m | <1% | 189 | 150 | $8K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 545 | 199 | $6K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 59 | 51 | $865.53 |
| 99292 | <1% | 29 | 26 | $639.00 | |
| 94060 | <1% | 14 | 13 | $243.92 | |
| 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 | <1% | 46 | 40 | $193.40 |
| 94729 | <1% | 14 | 14 | $35.94 | |
| 94727 | <1% | 12 | 12 | $33.24 | |
| G0316 | Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes) | <1% | 12 | 12 | $6.12 |
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 officialMCDANIEL, APRIL (BILLING SUPERVISOR)