Physician
Sumner Physician Practices LLC
Sumner Physician Practices LLC was paid $457K by Medicaid between Jan 2018 and Dec 2024, across 30 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 48% of everything it billed.
33Billing provider infoSUMNER PHYSICIAN PRACTICES LLC
GALLATIN, TN 37066
GALLATIN, TN 37066
33aNPI1730541145assigned 03/24/2016
33bProvider typeFamily Medicine Physician
28Total paid$457K
24GClaims40,228
24DCodes billed30
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Tennessee
Rank by total paid#110 of 754
Median peer was paid$34K
This provider vs. median14×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official LAWRENCE, CHARLOTTE controls 20+ related entities in our dataset. Read more
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 | 1,524 | $45K | |
| 2019 | 1,320 | $40K | |
| 2020 | 1,383 | $46K | |
| 2021 | 2,396 | $69K | |
| 2022 | 9,512 | $73K | |
| 2023 | 13,430 | $113K | |
| 2024incomplete | 10,663 | $71K |
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 | 48% | 5,553 | 4,110 | $219K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 45% | 6,283 | 4,551 | $203K |
| 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 | 3.6% | 265 | 205 | $17K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.1% | 879 | 586 | $10K |
| 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% | 470 | 315 | $2K |
| 90674 | <1% | 101 | 76 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 139 | 109 | $1K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 39 | 24 | $686.69 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 50 | 25 | $621.03 |
| 90686 | <1% | 48 | 43 | $572.96 | |
| 3079F | <1% | 1,975 | 1,515 | $550.00 | |
| 3074F | <1% | 3,000 | 2,268 | $470.02 |
18 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 48 | $398.27 |
| 3078F | <1% | 1,872 | $231.87 | |
| 99442 | <1% | 31 | $229.80 | |
| 90656 | <1% | 19 | $214.38 | |
| 3077F | <1% | 590 | $200.00 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 124 | $136.19 |
| 3080F | <1% | 444 | $130.00 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 18 | $73.65 |
| 3075F | <1% | 471 | $62.53 | |
| 81002 | <1% | 21 | $36.94 | |
| 1036F | <1% | 3,428 | $0.04 | |
| 1159F | <1% | 3,949 | $0.02 | |
| 1160F | <1% | 3,951 | $0.02 | |
| 1034F | 0% | 1,109 | $0.00 | |
| 3008F | 0% | 3,982 | $0.00 | |
| 1125F | 0% | 771 | $0.00 | |
| 1126F | 0% | 486 | $0.00 | |
| 3725F | 0% | 112 | $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 officialLAWRENCE, CHARLOTTE (SECRETARY)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.