Physician
Physician Coverage Services PC
Physician Coverage Services PC was paid $16.59M by Medicaid between Jan 2018 and Dec 2024, across 172 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoPHYSICIAN COVERAGE SERVICES PC
FLINT, MI 48503
FLINT, MI 48503
33aNPI1669567806assigned 10/04/2006
33bProvider typePediatrics Physician
28Total paid$16.59M
24GClaims1,011,764
24DCodes billed172
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Michigan
Rank by total paid#2 of 349
Median peer was paid$321K
This provider vs. median52×
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 | 50,710 | $2.05M | |
| 2019 | 49,179 | $2.02M | |
| 2020 | 176,862 | $2.19M | |
| 2021 | 159,563 | $2.54M | |
| 2022 | 154,385 | $2.43M | |
| 2023 | 216,505 | $2.75M | |
| 2024incomplete | 204,560 | $2.61M |
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 | 34% | 101,144 | 88,357 | $5.68M |
| 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 | 34% | 70,842 | 66,472 | $5.62M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.8% | 17,068 | 5,062 | $626K |
| 99223 | Prolong inpt eval add15 m | 3.1% | 5,375 | 4,974 | $512K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 3.0% | 5,765 | 5,730 | $500K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 3.0% | 9,067 | 3,127 | $496K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 2.5% | 4,333 | 4,316 | $411K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.0% | 4,214 | 4,182 | $327K |
| 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 | 1.5% | 2,083 | 2,072 | $254K |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.5% | 4,563 | 4,284 | $249K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 4,502 | 4,273 | $155K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 1,353 | 1,320 | $143K |
160 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 1,637 | $141K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 1,554 | $130K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 1,521 | $127K |
| 99496 | <1% | 960 | $122K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 1,591 | $108K |
| 90682 | <1% | 1,460 | $78K | |
| 99220 | <1% | 935 | $78K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 2,639 | $78K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 8,756 | $72K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 1,047 | $71K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 2,768 | $58K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 4,460 | $43K |
| 99495 | <1% | 383 | $40K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 903 | $35K |
| 99406 | <1% | 4,441 | $35K | |
| 81002 | <1% | 13,048 | $33K | |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 1,241 | $28K |
| 90686 | <1% | 2,124 | $26K | |
| 93000 | <1% | 3,034 | $25K | |
| 81025 | <1% | 3,670 | $25K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,105 | $24K |
| 99349 | <1% | 358 | $20K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 327 | $17K |
| 99217 | <1% | 485 | $16K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 688 | $16K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 1,519 | $16K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,057 | $16K |
| 99487 | Ccm add 20min | <1% | 236 | $10K |
| 96160 | <1% | 978 | $10K | |
| 90673 | <1% | 141 | $10K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 614 | $9K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 663 | $9K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 4,686 | $7K |
| 99235 | <1% | 72 | $6K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 404 | $6K |
| 99443 | <1% | 260 | $6K | |
| 94010 | <1% | 331 | $6K | |
| 99442 | <1% | 273 | $6K | |
| 99385 | <1% | 47 | $5K | |
| 94060 | <1% | 148 | $5K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 169 | $3K |
| 97162 | <1% | 68 | $3K | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 252 | $3K |
| 69210 | <1% | 113 | $3K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 287 | $3K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 391 | $3K |
| 99219 | <1% | 39 | $2K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 56 | $2K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 109 | $2K |
| 98966 | <1% | 753 | $2K | |
| 97116 | <1% | 110 | $2K | |
| 99383 | <1% | 15 | $2K | |
| 99348 | <1% | 58 | $1K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 44 | $1K |
| 86580 | <1% | 220 | $1K | |
| 90656 | <1% | 75 | $1K | |
| 97164 | <1% | 30 | $971.26 | |
| 90670 | <1% | 569 | $830.14 | |
| 72100 | <1% | 43 | $776.91 | |
| 98967 | <1% | 202 | $745.33 | |
| 20610 | <1% | 18 | $680.94 | |
| 82947 | <1% | 241 | $660.15 | |
| 99407 | <1% | 44 | $619.11 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 37 | $582.96 |
| 82274 | <1% | 39 | $570.34 | |
| 98968 | <1% | 81 | $569.43 | |
| 90662 | <1% | 84 | $559.26 | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 82 | $485.66 |
| 82962 | <1% | 272 | $428.74 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 478 | $417.93 |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 135 | $404.56 |
| 98940 | <1% | 30 | $388.31 | |
| 99441 | <1% | 48 | $373.23 | |
| 97014 | <1% | 49 | $359.17 | |
| 99226 | <1% | 67 | $340.12 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 108 | $199.98 |
| 90715 | <1% | 258 | $199.18 | |
| 73560 | <1% | 14 | $184.87 | |
| 90716 | <1% | 12 | $176.20 | |
| 97035 | <1% | 165 | $164.17 | |
| G0008 | Administration of influenza virus vaccine | <1% | 384 | $134.76 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | <1% | 50 | $111.50 |
| 90707 | <1% | 12 | $53.17 | |
| G9007 | Coordinated care fee, scheduled team conference | <1% | 1,840 | $2.09 |
| 3074F | <1% | 47,146 | $1.38 | |
| G9008 | Coordinated care fee, physician coordinated care oversight services | <1% | 790 | $1.35 |
| G9001 | Coordinated care fee, initial rate | <1% | 866 | $1.26 |
| 3077F | <1% | 15,293 | $0.61 | |
| G9002 | Coordinated care fee, maintenance rate | <1% | 942 | $0.53 |
| 3075F | <1% | 16,522 | $0.36 | |
| 3079F | 0% | 34,243 | $0.00 | |
| 3044F | 0% | 23,761 | $0.00 | |
| 90651 | 0% | 366 | $0.00 | |
| 3080F | 0% | 13,969 | $0.00 | |
| 4008F | 0% | 14,321 | $0.00 | |
| 1111F | 0% | 22,621 | $0.00 | |
| 97010 | 0% | 262 | $0.00 | |
| 1034F | 0% | 22,325 | $0.00 | |
| 1000F | 0% | 64,143 | $0.00 | |
| 3014F | 0% | 6,764 | $0.00 | |
| 4000F | 0% | 1,176 | $0.00 | |
| G8422 | Bmi not documented, documentation the patient is not eligible for bmi calculation | 0% | 781 | $0.00 |
| 3052F | 0% | 1,389 | $0.00 | |
| 3061F | 0% | 3,990 | $0.00 | |
| 3060F | 0% | 1,940 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 123 | $0.00 |
| 1036F | 0% | 42,368 | $0.00 | |
| 90744 | 0% | 119 | $0.00 | |
| 3066F | 0% | 3,575 | $0.00 | |
| G8432 | Depression screening not documented, reason not given | 0% | 138 | $0.00 |
| 90698 | 0% | 266 | $0.00 | |
| 1031F | 0% | 6,173 | $0.00 | |
| 1035F | 0% | 673 | $0.00 | |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | 0% | 1,649 | $0.00 |
| 4010F | 0% | 20,075 | $0.00 | |
| 3017F | 0% | 10,936 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 7,232 | $0.00 |
| G8732 | No documentation of pain assessment, reason not given | 0% | 253 | $0.00 |
| 4037F | 0% | 1,175 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 93 | $0.00 |
| 4140F | 0% | 11,537 | $0.00 | |
| S0257 | Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service) | 0% | 63 | $0.00 |
| 90619 | 0% | 55 | $0.00 | |
| 90696 | 0% | 31 | $0.00 | |
| 90680 | 0% | 65 | $0.00 | |
| 1101F | 0% | 31 | $0.00 | |
| 91301 | 0% | 14 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 16,389 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 1,890 | $0.00 |
| 90461 | 0% | 129 | $0.00 | |
| 3023F | 0% | 305 | $0.00 | |
| 3078F | 0% | 30,271 | $0.00 | |
| 3046F | 0% | 3,512 | $0.00 | |
| 90734 | 0% | 278 | $0.00 | |
| 1160F | 0% | 62,713 | $0.00 | |
| 1159F | 0% | 62,683 | $0.00 | |
| 3725F | 0% | 11,694 | $0.00 | |
| 4025F | 0% | 29,295 | $0.00 | |
| 4013F | 0% | 19,019 | $0.00 | |
| 4001F | 0% | 4,492 | $0.00 | |
| G8598 | Aspirin or another antiplatelet therapy used | 0% | 13,948 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 32 | $0.00 |
| 3051F | 0% | 2,156 | $0.00 | |
| G8421 | Bmi not documented and no reason is given | 0% | 1,365 | $0.00 |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 20 | $0.00 |
| 4040F | 0% | 19,848 | $0.00 | |
| 90633 | 0% | 457 | $0.00 | |
| 1033F | 0% | 4,998 | $0.00 | |
| 1032F | 0% | 1,551 | $0.00 | |
| 2022F | 0% | 2,984 | $0.00 | |
| 4187F | 0% | 1,595 | $0.00 | |
| 3015F | 0% | 7,881 | $0.00 | |
| 4004F | 0% | 327 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 75 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 235 | $0.00 |
| 1040F | 0% | 140 | $0.00 | |
| 90710 | 0% | 77 | $0.00 | |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 95 | $0.00 |
| 90700 | 0% | 16 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 16 | $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 officialKROMER, GAIL (BILLER)