Physician
Pueblo Pulmonary Associates
Pueblo Pulmonary Associates was paid $5.35M by Medicaid between Jan 2018 and Dec 2023, across 37 billing codes. Its largest line is 99233, hospital visit by a doctor, follow-up day (complex) — 28% of everything it billed.
33Billing provider infoPUEBLO PULMONARY ASSOCIATES
PUEBLO, CO 81003
PUEBLO, CO 81003
33aNPI1760688444assigned 06/21/2007
33bProvider typePulmonary Disease Physician
28Total paid$5.35M
24GClaims102,158
24DCodes billed37
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other Pulmonary Disease Physician providers in Colorado
Rank by total paid#3 of 30
Median peer was paid$72K
This provider vs. median74×
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 | 13,372 | $775K | |
| 2019 | 19,239 | $930K | |
| 2020 | 16,982 | $890K | |
| 2021 | 18,819 | $988K | |
| 2022 | 17,526 | $903K | |
| 2023 | 16,220 | $869K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 28% | 27,837 | 11,412 | $1.51M |
| 99223 | Prolong inpt eval add15 m | 18% | 9,283 | 8,524 | $938K |
| 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 | 17% | 16,890 | 14,630 | $884K |
| 95811 | 8.3% | 4,445 | 3,961 | $442K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 6.7% | 4,413 | 3,771 | $360K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 5.9% | 8,609 | 5,943 | $314K |
| 95806 | 5.3% | 3,443 | 1,900 | $286K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.1% | 7,077 | 6,380 | $272K |
| 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 | 3.3% | 1,971 | 1,753 | $174K |
| 95800 | 1.2% | 925 | 420 | $66K | |
| 94060 | <1% | 3,585 | 3,346 | $29K | |
| 94010 | <1% | 1,460 | 1,210 | $21K |
25 more codes
| 94726 | <1% | 2,943 | $21K | |
| 94729 | <1% | 3,046 | $14K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 77 | $10K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 63 | $4K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 42 | $2K |
| 94004 | <1% | 413 | $1K | |
| 94618 | <1% | 58 | $960.63 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 53 | $907.29 |
| 99406 | <1% | 33 | $364.24 | |
| 99407 | <1% | 27 | $323.72 | |
| 99442 | <1% | 15 | $193.94 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 3,622 | $0.00 |
| G9744 | Patient not eligible due to active diagnosis of hypertension | 0% | 34 | $0.00 |
| G9695 | Long-acting inhaled bronchodilator prescribed | 0% | 281 | $0.00 |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 91 | $0.00 |
| G8938 | Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible | 0% | 12 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 12 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 24 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 14 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 868 | $0.00 |
| 1036F | 0% | 345 | $0.00 | |
| 1111F | 0% | 79 | $0.00 | |
| G8422 | Bmi not documented, documentation the patient is not eligible for bmi calculation | 0% | 44 | $0.00 |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 12 | $0.00 |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 12 | $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 officialSHAPIRO, CRAIG (MANAGING PARTNER)
| Provider | Location | Paid |
|---|---|---|
| Middletown Dental PC | Middletown, NY | $31K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.