Physician
Prathipati, Sushmita
Prathipati, Sushmita was paid $178K by Medicaid between Jan 2018 and Feb 2023, across 10 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 56% of everything it billed.
33Billing provider infoPRATHIPATI, SUSHMITA
ROCHELLE, IL 61068
ROCHELLE, IL 61068
33aNPI1740581776assigned 11/08/2010
33bProvider typeObesity Medicine (Family Medicine) Physician
28Total paid$178K
24GClaims4,052
24DCodes billed10
24AFirst – last monthJan 2018 – Feb 2023
Compared with peers
Next to other Obesity Medicine (Family Medicine) Physician providers in Illinois
Rank by total paid#4 of 11
Median peer was paid$143K
This provider vs. median1.2×
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 | 1,382 | $50K | |
| 2019 | 322 | $15K | |
| 2020 | 324 | $13K | |
| 2021 | 911 | $44K | |
| 2022 | 978 | $51K | |
| 2023 | 135 | $5K |
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 | 56% | 2,585 | 2,345 | $100K |
| 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 | 39% | 1,155 | 1,039 | $70K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.5% | 59 | 56 | $3K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.4% | 30 | 29 | $3K |
| 90715 | <1% | 57 | 36 | $1K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 26 | 24 | $918.58 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 28 | 27 | $381.73 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 15 | 12 | $184.66 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 72 | 51 | $3.96 |
| 36415 | Collection of venous blood by venipuncture | 0% | 25 | 25 | $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.