Physician
Sumner Physician Practices LLC
Sumner Physician Practices LLC was paid $672K by Medicaid between Mar 2018 and Dec 2024, across 43 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 42% of everything it billed.
33Billing provider infoSUMNER PHYSICIAN PRACTICES LLC
GALLATIN, TN 37066
GALLATIN, TN 37066
33aNPI1730637190assigned 09/14/2016
33bProvider typeInternal Medicine Physician
28Total paid$672K
24GClaims35,626
24DCodes billed43
24AFirst – last monthMar 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in Tennessee
Rank by total paid#49 of 581
Median peer was paid$15K
This provider vs. median44×
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 | 76 | $4K | |
| 2019 | 361 | $6K | |
| 2020 | 2,150 | $51K | |
| 2021 | 6,278 | $181K | |
| 2022 | 7,121 | $123K | |
| 2023 | 6,354 | $153K | |
| 2024incomplete | 13,286 | $155K |
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% | 6,129 | 5,313 | $282K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 34% | 9,194 | 6,859 | $226K |
| 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 | 13% | 1,280 | 1,021 | $90K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 6.3% | 977 | 833 | $43K |
| 20610 | 1.7% | 435 | 261 | $11K | |
| 73110 | <1% | 248 | 181 | $3K | |
| 73562 | <1% | 230 | 183 | $3K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 169 | 148 | $2K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 75 | 43 | $2K |
| 11720 | <1% | 251 | 160 | $1K | |
| 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% | 320 | 213 | $805.61 |
| 73100 | <1% | 62 | 41 | $758.07 |
31 more codes
| 97597 | <1% | 94 | $749.38 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 14 | $718.00 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 343 | $705.87 |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 18 | $642.10 |
| 73610 | <1% | 55 | $629.13 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 196 | $555.42 |
| 95251 | <1% | 72 | $496.46 | |
| 87428 | <1% | 18 | $480.77 | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 15 | $412.01 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 50 | $380.23 |
| 11056 | <1% | 66 | $287.74 | |
| 11719 | <1% | 188 | $230.55 | |
| 99442 | <1% | 19 | $215.67 | |
| 3074F | <1% | 1,729 | $181.20 | |
| 3078F | <1% | 1,680 | $170.00 | |
| 73560 | <1% | 18 | $136.81 | |
| 11721 | <1% | 18 | $114.06 | |
| 72100 | <1% | 16 | $111.80 | |
| 3079F | <1% | 194 | $101.19 | |
| 73020 | <1% | 15 | $98.57 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 84 | $50.40 |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 23 | $45.75 |
| 3075F | <1% | 34 | $30.00 | |
| 1036F | <1% | 2,025 | $0.02 | |
| 99024 | 0% | 3,633 | $0.00 | |
| 3008F | 0% | 2,912 | $0.00 | |
| 1126F | 0% | 49 | $0.00 | |
| 1034F | 0% | 94 | $0.00 | |
| 1035F | 0% | 13 | $0.00 | |
| 1160F | 0% | 1,285 | $0.00 | |
| 1159F | 0% | 1,286 | $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.