Great Lakes Physician Practice PC
Great Lakes Physician Practice PC was paid $8.88M by Medicaid between Jan 2018 and Dec 2024, across 85 billing codes. Its largest line is 99284, emergency room visit (serious) — 29% of everything it billed.
JAMESTOWN, NY 14701
Next to other Pulmonary Disease Physician providers in New York
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 8,144 | $390K | |
| 2019 | 11,027 | $600K | |
| 2020 | 20,162 | $1.28M | |
| 2021 | 22,876 | $1.61M | |
| 2022 | 25,555 | $1.78M | |
| 2023 | 30,450 | $1.90M | |
| 2024incomplete | 21,515 | $1.32M |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 29% | 34,905 | 34,336 | $2.56M |
| 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 | 26% | 31,566 | 30,298 | $2.26M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 17% | 14,027 | 13,862 | $1.49M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 9.9% | 18,060 | 17,212 | $880K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2.6% | 2,954 | 2,942 | $231K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 2.0% | 2,061 | 2,058 | $178K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 1.8% | 3,558 | 3,545 | $163K |
| 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 | 1.8% | 1,525 | 1,525 | $156K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.6% | 1,987 | 1,986 | $141K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.3% | 1,368 | 1,367 | $112K |
| 90682 | <1% | 1,210 | 1,206 | $67K | |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 420 | 420 | $60K |
73 more codes
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 430 | $51K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 573 | $43K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 327 | $42K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 334 | $40K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 742 | $36K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 327 | $31K |
| 99460 | <1% | 537 | $25K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 935 | $23K |
| 99406 | <1% | 2,341 | $22K | |
| 93000 | <1% | 1,372 | $19K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 420 | $18K |
| 99223 | Prolong inpt eval add15 m | <1% | 215 | $17K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 204 | $15K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 436 | $12K |
| 94060 | <1% | 770 | $12K | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 1,426 | $11K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,725 | $10K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,037 | $9K |
| 20610 | <1% | 238 | $9K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 276 | $8K |
| 94726 | <1% | 806 | $8K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 487 | $7K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 1,254 | $7K |
| 99221 | <1% | 138 | $6K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 141 | $6K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 81 | $6K |
| 54150 | <1% | 85 | $5K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 276 | $5K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 620 | $5K |
| 90732 | <1% | 47 | $5K | |
| 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% | 524 | $5K |
| 95806 | <1% | 119 | $4K | |
| 90677 | <1% | 15 | $4K | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 249 | $4K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 48 | $4K |
| 95811 | <1% | 26 | $4K | |
| 90715 | <1% | 70 | $3K | |
| 94729 | <1% | 461 | $3K | |
| 99442 | <1% | 79 | $3K | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 307 | $2K |
| 93227 | <1% | 53 | $2K | |
| 31575 | <1% | 28 | $2K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 16 | $2K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 12 | $2K |
| 93016 | <1% | 108 | $2K | |
| 59025 | Fetal non-stress test | <1% | 52 | $2K |
| 93018 | <1% | 107 | $1K | |
| 90674 | <1% | 39 | $1K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 88 | $1K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 14 | $954.56 |
| 99443 | <1% | 17 | $858.05 | |
| 71045 | Radiologic examination, chest; single view | <1% | 142 | $811.78 |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 14 | $668.95 |
| G0406 | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth | <1% | 21 | $558.62 |
| 94010 | <1% | 16 | $432.48 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 40 | $268.01 |
| 76642 | <1% | 12 | $256.66 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 48 | $223.36 |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 46 | $218.80 |
| 99243 | <1% | 16 | $184.30 | |
| 81003 | <1% | 66 | $108.08 | |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | <1% | 12 | $94.11 |
| 76641 | <1% | 13 | $91.64 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 12 | $85.00 |
| 81025 | <1% | 25 | $50.88 | |
| 81002 | <1% | 92 | $43.85 | |
| 92504 | <1% | 12 | $42.88 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 51 | $37.23 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 4,200 | $33.63 |
| 82962 | <1% | 59 | $4.65 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 13 | $0.12 |
| 97010 | 0% | 133 | $0.00 | |
| G9920 | Screening performed and negative | 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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Urgent Care, INC.- West Virginia | South Charleston, WV | $66.96M |
| University of Pittsburgh Physicians | Pittsburgh, PA | $23.58M |
| Upmc Altoona | Altoona, PA | $394K |
| University of Pittsburgh Physicians | Pittsburgh, PA | $287K |
| Upmc Altoona | Altoona, PA | $230K |
| Upmc Altoona | Altoona, PA | $165K |
| University of Pittsburgh Physicians | Pittsburgh, PA | $128K |
| Upmc Western Maryland Health Services, LLC | Cumberland, MD | $107K |
| Upmc Advanced Practice Providers | Pittsburgh, PA | $75K |
| Upmc Western Maryland Health Services, LLC | Cumberland, MD | $38K |
| Upmc Western Maryland Health Services, LLC | Frostburg, MD | $21K |
| University of Pittsburgh Physicians | Pittsburgh, PA | $14K |
| University of Pittsburgh Physicians | Clarion, PA | $4K |
| Upmc Western Maryland Health Services, LLC | Cumberland, MD | $2K |
| Upmc Western Maryland Health Services, LLC | Cumberland, MD | $1K |
| Upmc Community Medicine, INC | Pittsburgh, PA | $1K |
| Upmc Western Maryland Health Services, LLC | Mc Henry, MD | $949.96 |
| Upmc Western Maryland Health Services, LLC | Frostburg, MD | $406.73 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.