Gautam, Prachi
Gautam, Prachi was paid $195K by Medicaid between Nov 2018 and Oct 2024, across 20 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoGAUTAM, PRACHI
BRONX, NY 10453
BRONX, NY 10453
33aNPI1740687755assigned 11/20/2014
33bProvider typeStudent in an Organized Health Care Education/Training Program
28Total paid$195K
24GClaims4,683
24DCodes billed20
24AFirst – last monthNov 2018 – Oct 2024
Compared with peers
Next to other Student in an Organized Health Care Education/Training Program providers in New York
Rank by total paid#76 of 2,013
Median peer was paid$4K
This provider vs. median53×
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 | 12 | $497.40 | |
| 2019 | 604 | $24K | |
| 2020 | 2,132 | $87K | |
| 2021 | 1,242 | $51K | |
| 2022 | 666 | $31K | |
| 2023 | 15 | $1K | |
| 2024incomplete | 12 | $804.36 |
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 | 34% | 1,307 | 1,153 | $66K |
| 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 | 25% | 667 | 593 | $48K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 675 | 654 | $21K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 11% | 554 | 526 | $21K |
| 99441 | 6.3% | 334 | 309 | $12K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.4% | 99 | 99 | $7K |
| 90756 | 2.7% | 372 | 367 | $5K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.1% | 150 | 149 | $4K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.9% | 54 | 54 | $4K |
| 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 | 1.7% | 70 | 70 | $3K |
| 99442 | <1% | 23 | 21 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 87 | 83 | $1K |
8 more codes
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 12 | $888.00 |
| T1013 | Sign language or oral interpretive services, per 15 minutes | <1% | 48 | $242.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 33 | $190.30 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 36 | $169.65 |
| 90461 | <1% | 13 | $168.19 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 106 | $2.55 |
| V5008 | Hearing screening | 0% | 27 | $0.00 |
| 2010F | 0% | 16 | $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.