Gadalla, Hisham

Gadalla, Hisham was paid $723K by Medicaid between Jan 2018 and Nov 2023, across 45 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.

33Billing provider infoGADALLA, HISHAM
CLIFTON, NJ 07011

33aNPI1689666257assigned 08/18/2005

33bProvider typePediatrics Physician

28Total paid$723K

24GClaims23,425

24DCodes billed45

24AFirst – last monthJan 2018 – Nov 2023

Compared with peers

Next to other Pediatrics Physician providers in New Jersey

Rank by total paid#137 of 549

Median peer was paid$154K

This provider vs. median4.7×

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	8,580	$241K
2019	8,556	$255K
2020	4,943	$170K
2021	694	$28K
2022	170	$7K
2023	482	$21K

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	37%	6,517	5,269	$270K
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	19%	2,209	2,030	$135K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	5.3%	658	604	$38K
99238	Hospital discharge day management, 30 minutes or less	4.9%	626	619	$36K
90460	Immunization administration through 18 years of age via any route, first or only component	4.8%	1,575	1,536	$35K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	4.7%	561	543	$34K
99460		4.1%	590	589	$29K
99462		2.8%	623	554	$21K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.6%	309	305	$19K
97802		2.6%	1,019	1,009	$18K
95930		1.8%	297	297	$13K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	1.5%	436	427	$11K

33 more codes

96110	Developmental screening, with scoring and documentation, per standardized instrument	1.5%	1,699	$11K
99188		1.5%	339	$11K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	748	$6K
94664		<1%	498	$5K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	76	$5K
92587		<1%	346	$4K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	220	$4K
99401		<1%	164	$3K
95004	Percutaneous tests with allergenic extracts, immediate type reaction	<1%	14	$3K
99203	Doctor's office visit, new patient (routine)	<1%	42	$3K
99442		<1%	32	$1K
36415	Collection of venous blood by venipuncture	<1%	708	$1K
90670		<1%	210	$1K
90688		<1%	473	$964.49
90700		<1%	478	$738.55
96127		<1%	216	$710.09
90713		<1%	332	$564.54
90472	Immunization administration, each additional vaccine (list separately)	<1%	28	$552.00
90716		<1%	72	$320.84
90633		<1%	81	$256.00
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	106	$212.37
86580		<1%	40	$196.58
90647		<1%	156	$192.56
90707		<1%	59	$187.45
90649		<1%	14	$165.49
90620		<1%	12	$160.75
90734		<1%	24	$116.30
83655		<1%	39	$78.53
90687		<1%	32	$52.09
90744		<1%	171	$23.95
90461		0%	432	$0.00
90680		0%	43	$0.00
99000		0%	101	$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.