Sanacore, John

Sanacore, John was paid $169K by Medicaid between Jan 2018 and Nov 2024, across 12 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 83% of everything it billed.

33Billing provider infoSANACORE, JOHN
JOHNSTON, RI 02919

33aNPI1700953395assigned 11/29/2006

33bProvider typePediatrics Physician

28Total paid$169K

24GClaims3,389

24DCodes billed12

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Pediatrics Physician providers in Rhode Island

Rank by total paid#110 of 265

Median peer was paid$133K

This provider vs. median1.3×

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	961	$37K
2019	355	$15K
2020	302	$7K
2021	257	$8K
2022	525	$30K
2023	615	$43K
2024incomplete	374	$29K

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	83%	1,920	1,672	$141K
90460	Immunization administration through 18 years of age via any route, first or only component	9.7%	924	878	$16K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.7%	43	39	$5K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	1.4%	29	24	$2K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	17	12	$1K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	82	39	$1K
90461		<1%	39	37	$1K
87811	Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19)	<1%	13	13	$499.69
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	40	39	$417.63
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)	<1%	19	19	$235.51
90686		<1%	198	196	$99.00
S9451	Exercise classes, non-physician provider, per session	<1%	65	61	$0.65

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.