Kentuckiana Pulmonary Associates, PLLC

Kentuckiana Pulmonary Associates, PLLC was paid $1.93M by Medicaid between Jan 2018 and Oct 2020, across 23 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 57% of everything it billed.

33Billing provider infoKENTUCKIANA PULMONARY ASSOCIATES, PLLC
LOUISVILLE, KY 40202

33aNPI1699725598assigned 05/11/2006

33bProvider typeNurse Practitioner

28Total paid$1.93M

24GClaims52,102

24DCodes billed23

24AFirst – last monthJan 2018 – Oct 2020

Compared with peers

Next to other Nurse Practitioner providers in Kentucky

Rank by total paid#28 of 260

Median peer was paid$89K

This provider vs. median22×

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	18,127	$602K
2019	19,392	$692K
2020	14,583	$634K

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	57%	13,915	5,002	$1.10M
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	27%	24,513	9,494	$519K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	4.6%	3,373	2,004	$89K
99231	Subsequent hospital care, per day, straightforward or low complexity	4.0%	4,869	1,283	$78K
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	2.0%	1,351	1,140	$38K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.7%	1,421	1,190	$33K
99222	Initial hospital care, per day, moderate complexity	<1%	456	414	$18K
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%	185	167	$15K
99223	Prolong inpt eval add15 m	<1%	249	216	$14K
99308	Subsequent nursing facility care, per day, straightforward	<1%	243	61	$5K
94726		<1%	488	429	$5K
94729		<1%	455	402	$4K

11 more codes

99239	Hospital discharge day management, more than 30 minutes	<1%	94	$3K
95800		<1%	68	$2K
95810	Polysomnography; sleep staging with 4 or more additional parameters	<1%	24	$2K
99254		<1%	14	$1K
99442		<1%	107	$1K
94060		<1%	138	$939.27
G0399	Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation	<1%	23	$267.47
98967		<1%	27	$193.78
94010		<1%	16	$154.11
36415	Collection of venous blood by venipuncture	<1%	57	$93.44
95012		<1%	16	$75.21

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 officialMCCONNELL, JOHN (PRESIDENT)