Pioneer Valley Urology, PC

Pioneer Valley Urology, PC was paid $1.73M by Medicaid between Jan 2018 and Nov 2024, across 40 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 48% of everything it billed.

33Billing provider infoPIONEER VALLEY UROLOGY, PC
SPRINGFIELD, MA 01107

33aNPI1750315982assigned 07/11/2006

33bProvider typeUrology Physician

28Total paid$1.73M

24GClaims83,661

24DCodes billed40

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Urology Physician providers in Massachusetts

Rank by total paid#2 of 65

Median peer was paid$4K

This provider vs. median471×

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	11,747	$250K
2019	12,182	$208K
2020	8,234	$186K
2021	9,694	$212K
2022	13,801	$376K
2023	13,635	$286K
2024incomplete	14,368	$212K

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%	20,417	19,956	$824K
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	19%	3,883	3,856	$324K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	18%	10,947	10,736	$305K
51798		4.4%	13,619	13,388	$76K
87798	Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism	2.4%	289	276	$41K
81003		1.0%	18,986	18,339	$18K
87481		<1%	288	275	$17K
84153		<1%	2,694	2,626	$16K
87801	Infectious agent detection by nucleic acid; amplified probe, multiple organisms	<1%	287	274	$14K
51784		<1%	673	463	$13K
88112		<1%	1,005	957	$12K
51797		<1%	429	276	$10K

28 more codes

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%	3,158	$9K
76770		<1%	267	$9K
87641		<1%	274	$7K
88120		<1%	40	$6K
52000		<1%	79	$5K
87640		<1%	287	$4K
87653		<1%	287	$4K
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	<1%	287	$4K
36415	Collection of venous blood by venipuncture	<1%	4,187	$2K
51728		<1%	32	$2K
99223	Prolong inpt eval add15 m	<1%	13	$1K
55700		<1%	12	$1K
87500		<1%	127	$1K
51705		<1%	25	$896.14
52287		<1%	13	$754.91
99233	Hospital visit by a doctor, follow-up day (complex)	<1%	16	$712.37
51741		<1%	194	$396.00
76775		<1%	27	$391.91
76872		<1%	20	$368.50
ATP02		<1%	163	$295.35
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	13	$192.98
82565		<1%	230	$166.28
84520		<1%	216	$123.37
76857		<1%	25	$98.15
80048	Basic metabolic panel (calcium, ionized)	<1%	12	$53.52
ATP08		<1%	26	$43.65
80051		<1%	64	$23.15
82947		<1%	50	$12.49

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 officialGELLOCK, SALLY (CREDENTIALING)