Physician
Prohealth Physicians PC
Prohealth Physicians PC was paid $80.49M by Medicaid between Jan 2018 and Dec 2024, across 186 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 42% of everything it billed.
33Billing provider infoPROHEALTH PHYSICIANS PC
FARMINGTON, CT 06032
FARMINGTON, CT 06032
33aNPI1720194053assigned 08/21/2006
33bProvider typeInternal Medicine Physician
28Total paid$80.49M
24GClaims1,762,658
24DCodes billed186
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in Connecticut
Rank by total paid#3 of 295
Median peer was paid$35K
This provider vs. median2,289×
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 | 226,052 | $10.97M | |
| 2019 | 245,133 | $11.84M | |
| 2020 | 200,149 | $9.03M | |
| 2021 | 280,816 | $12.47M | |
| 2022 | 281,092 | $12.85M | |
| 2023 | 283,840 | $13.13M | |
| 2024incomplete | 245,576 | $10.19M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 42% | 462,934 | 391,927 | $34.12M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 25% | 320,314 | 282,102 | $19.89M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.6% | 137,931 | 128,084 | $5.28M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.3% | 37,388 | 35,295 | $4.28M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.5% | 31,999 | 30,143 | $3.59M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.5% | 25,240 | 22,840 | $2.78M |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.2% | 15,060 | 14,172 | $1.80M |
| 96127 | 1.5% | 67,906 | 61,066 | $1.23M | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.4% | 25,995 | 23,240 | $1.10M |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 1.1% | 13,369 | 12,629 | $902K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 32,377 | 30,156 | $561K |
| 80061 | Lipid panel | <1% | 41,219 | 35,262 | $352K |
174 more codes
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 18,246 | $339K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 13,367 | $301K |
| 80053 | Comprehensive metabolic panel | <1% | 40,604 | $287K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 936 | $225K |
| 31231 | <1% | 3,030 | $212K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 2,888 | $190K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,813 | $171K |
| 95806 | <1% | 1,816 | $162K | |
| 99177 | <1% | 8,723 | $155K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 13,030 | $153K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 3,854 | $150K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 26,138 | $139K |
| 36416 | <1% | 44,963 | $135K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 5,988 | $118K |
| 99243 | <1% | 1,365 | $112K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 51,445 | $108K |
| 99173 | <1% | 13,239 | $87K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 13,820 | $82K |
| 92558 | <1% | 3,416 | $75K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 6,372 | $59K |
| 83655 | <1% | 5,626 | $59K | |
| 90674 | <1% | 13,732 | $57K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 4,108 | $57K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 2,018 | $56K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 2,747 | $56K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 668 | $53K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 1,715 | $51K |
| 92551 | <1% | 8,324 | $47K | |
| 96161 | <1% | 2,305 | $47K | |
| 92557 | <1% | 2,325 | $46K | |
| 31575 | <1% | 926 | $40K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 1,545 | $38K |
| 92583 | <1% | 1,870 | $37K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 328 | $36K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 545 | $34K |
| 0071A | <1% | 1,009 | $33K | |
| 0072A | <1% | 983 | $33K | |
| 90686 | <1% | 68,832 | $32K | |
| 99442 | <1% | 1,264 | $32K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,722 | $30K |
| 99051 | <1% | 5,947 | $30K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 270 | $25K |
| 80050 | General health panel | <1% | 1,009 | $25K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 1,571 | $24K |
| 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% | 14,697 | $24K |
| 94760 | <1% | 16,458 | $24K | |
| 92552 | <1% | 1,902 | $22K | |
| 90480 | <1% | 666 | $21K | |
| 93000 | <1% | 1,823 | $18K | |
| 82607 | <1% | 1,618 | $16K | |
| 90682 | <1% | 758 | $16K | |
| 96160 | <1% | 955 | $16K | |
| 69210 | <1% | 1,558 | $14K | |
| 99307 | <1% | 909 | $13K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 401 | $12K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 387 | $12K |
| 99443 | <1% | 244 | $10K | |
| 99406 | <1% | 919 | $9K | |
| 31579 | <1% | 129 | $9K | |
| 84439 | <1% | 1,394 | $9K | |
| 91320 | <1% | 170 | $9K | |
| 86803 | <1% | 765 | $8K | |
| 95811 | <1% | 41 | $8K | |
| 90677 | <1% | 1,637 | $8K | |
| 81001 | <1% | 3,502 | $7K | |
| 82043 | <1% | 1,821 | $6K | |
| 99306 | Prolong nursin fac eval 15m | <1% | 101 | $6K |
| 99381 | <1% | 61 | $5K | |
| 87070 | <1% | 727 | $5K | |
| 90651 | <1% | 1,286 | $4K | |
| 96111 | <1% | 45 | $4K | |
| 92504 | <1% | 379 | $4K | |
| 82570 | <1% | 1,247 | $3K | |
| 99347 | <1% | 173 | $3K | |
| 83718 | <1% | 450 | $3K | |
| 87634 | <1% | 50 | $3K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 266 | $2K |
| 92567 | <1% | 319 | $2K | |
| 92550 | <1% | 408 | $2K | |
| 99174 | <1% | 118 | $2K | |
| 99441 | <1% | 860 | $2K | |
| 87081 | <1% | 333 | $2K | |
| 82465 | <1% | 439 | $2K | |
| 90662 | <1% | 676 | $1K | |
| 0001A | <1% | 79 | $1K | |
| 85018 | <1% | 28,155 | $1K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 199 | $1K |
| 85027 | <1% | 292 | $1K | |
| 99304 | <1% | 31 | $1K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 62 | $1K |
| 0124A | <1% | 29 | $960.00 | |
| 84480 | <1% | 120 | $902.06 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 18 | $709.12 |
| 87807 | <1% | 65 | $675.55 | |
| 82728 | <1% | 55 | $586.53 | |
| 96380 | <1% | 47 | $574.56 | |
| 82746 | <1% | 43 | $519.48 | |
| 84436 | <1% | 132 | $495.64 | |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | <1% | 51 | $488.53 |
| 90653 | <1% | 115 | $488.40 | |
| 0112A | <1% | 12 | $480.00 | |
| 83550 | <1% | 67 | $466.91 | |
| 99050 | <1% | 31 | $450.24 | |
| 0154A | <1% | 12 | $440.00 | |
| 0111A | <1% | 25 | $440.00 | |
| 0002A | <1% | 23 | $440.00 | |
| 90732 | <1% | 32 | $431.00 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 56 | $373.96 |
| 83540 | <1% | 67 | $345.20 | |
| 80305 | <1% | 54 | $309.55 | |
| 82550 | <1% | 86 | $263.40 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 47 | $259.20 |
| 94060 | <1% | 17 | $255.78 | |
| 83735 | <1% | 50 | $237.95 | |
| 94761 | <1% | 69 | $204.80 | |
| 90688 | <1% | 18 | $196.24 | |
| 81002 | <1% | 2,291 | $194.04 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 238 | $176.73 |
| 82962 | <1% | 145 | $145.88 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 20 | $139.60 |
| 84450 | <1% | 50 | $134.82 | |
| 90734 | <1% | 440 | $115.55 | |
| 84460 | <1% | 65 | $114.18 | |
| 94762 | <1% | 19 | $113.61 | |
| 82947 | <1% | 77 | $105.00 | |
| 90785 | <1% | 48 | $103.04 | |
| 85652 | <1% | 38 | $82.98 | |
| 81003 | <1% | 319 | $78.46 | |
| 82044 | <1% | 44 | $61.18 | |
| 85007 | <1% | 14 | $45.92 | |
| 82248 | <1% | 19 | $44.73 | |
| 88738 | <1% | 209 | $36.40 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 240 | $11.05 |
| G0008 | Administration of influenza virus vaccine | <1% | 2,117 | $2.30 |
| G0009 | Administration of pneumococcal vaccine | <1% | 27 | $0.01 |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 119 | $0.01 |
| 90723 | 0% | 3,255 | $0.00 | |
| 90680 | 0% | 4,200 | $0.00 | |
| 1170F | 0% | 916 | $0.00 | |
| 90647 | 0% | 3,083 | $0.00 | |
| 90698 | 0% | 1,883 | $0.00 | |
| 91307 | 0% | 2,813 | $0.00 | |
| 91305 | 0% | 164 | $0.00 | |
| 99000 | 0% | 513 | $0.00 | |
| 90697 | 0% | 456 | $0.00 | |
| 90619 | 0% | 202 | $0.00 | |
| 90744 | 0% | 205 | $0.00 | |
| 1126F | 0% | 173 | $0.00 | |
| 90716 | 0% | 317 | $0.00 | |
| 90666 | 0% | 146 | $0.00 | |
| 4037F | 0% | 18 | $0.00 | |
| 90696 | 0% | 63 | $0.00 | |
| 99024 | 0% | 22 | $0.00 | |
| 1125F | 0% | 31 | $0.00 | |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source | 0% | 150 | $0.00 |
| 90632 | 0% | 12 | $0.00 | |
| 91300 | 0% | 271 | $0.00 | |
| 90670 | 0% | 10,052 | $0.00 | |
| 90661 | 0% | 8,831 | $0.00 | |
| 1160F | 0% | 2,024 | $0.00 | |
| 90685 | 0% | 1,463 | $0.00 | |
| 1159F | 0% | 2,024 | $0.00 | |
| 90707 | 0% | 344 | $0.00 | |
| 90648 | 0% | 920 | $0.00 | |
| 90633 | 0% | 1,955 | $0.00 | |
| 91321 | 0% | 208 | $0.00 | |
| 90710 | 0% | 175 | $0.00 | |
| 90672 | 0% | 13 | $0.00 | |
| 91312 | 0% | 29 | $0.00 | |
| 90621 | 0% | 12 | $0.00 | |
| 91311 | 0% | 84 | $0.00 | |
| 90681 | 0% | 42 | $0.00 | |
| 90715 | 0% | 12 | $0.00 | |
| 90700 | 0% | 13 | $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 officialDONAHUE, JENNIFER (CHIEF MEDICAL OFFICER)