Physician
Kumara Prathipati, M.D.,Inc
Kumara Prathipati, M.D.,Inc was paid $111K by Medicaid between Jan 2018 and Nov 2024, across 55 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 77% of everything it billed.
33Billing provider infoKUMARA PRATHIPATI, M.D.,INC
SAN DIEGO, CA 92115
SAN DIEGO, CA 92115
33aNPI1780709345assigned 03/20/2007
33bProvider typeInternal Medicine Physician
28Total paid$111K
24GClaims28,672
24DCodes billed55
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Internal Medicine Physician providers in California
Rank by total paid#617 of 2,679
Median peer was paid$13K
This provider vs. median8.8×
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 | 5,010 | $13K | |
| 2019 | 9,870 | $17K | |
| 2020 | 4,277 | $18K | |
| 2021 | 2,736 | $14K | |
| 2022 | 2,470 | $11K | |
| 2023 | 2,899 | $16K | |
| 2024incomplete | 1,410 | $22K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 77% | 3,630 | 3,366 | $86K |
| 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 | 12% | 3,526 | 3,354 | $13K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 9.3% | 3,922 | 3,654 | $10K |
| 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% | 83 | 83 | $613.89 |
| 90658 | <1% | 34 | 32 | $525.58 | |
| 90756 | <1% | 26 | 26 | $369.04 | |
| 1123F | <1% | 426 | 426 | $53.00 | |
| 99349 | <1% | 12 | 12 | $51.18 | |
| 1036F | <1% | 568 | 559 | $47.52 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 680 | 679 | $0.28 |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 307 | 306 | $0.17 |
| 3008F | 0% | 557 | 552 | $0.00 |
43 more codes
| 1000F | 0% | 790 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 1,405 | $0.00 |
| 3079F | 0% | 252 | $0.00 | |
| 3080F | 0% | 42 | $0.00 | |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 582 | $0.00 |
| 1170F | 0% | 492 | $0.00 | |
| 1126F | 0% | 290 | $0.00 | |
| 3074F | 0% | 1,249 | $0.00 | |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 399 | $0.00 |
| 1101F | 0% | 307 | $0.00 | |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 34 | $0.00 |
| 3014F | 0% | 32 | $0.00 | |
| 3017F | 0% | 47 | $0.00 | |
| 3044F | 0% | 260 | $0.00 | |
| G8473 | Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed | 0% | 12 | $0.00 |
| 3075F | 0% | 91 | $0.00 | |
| 1034F | 0% | 54 | $0.00 | |
| 4010F | 0% | 13 | $0.00 | |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 28 | $0.00 |
| 4000F | 0% | 52 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 14 | $0.00 |
| 3077F | 0% | 163 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 1,368 | $0.00 |
| G8731 | Pain assessment using a standardized tool is documented as negative, no follow-up plan required | 0% | 154 | $0.00 |
| 3016F | 0% | 610 | $0.00 | |
| 3015F | 0% | 45 | $0.00 | |
| 1158F | 0% | 235 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 384 | $0.00 |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | 0% | 524 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 24 | $0.00 |
| 3725F | 0% | 454 | $0.00 | |
| 3078F | 0% | 1,257 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 674 | $0.00 |
| 3720F | 0% | 445 | $0.00 | |
| 1159F | 0% | 618 | $0.00 | |
| G9916 | Functional status performed once in the last 12 months | 0% | 401 | $0.00 |
| 1160F | 0% | 605 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 45 | $0.00 |
| 3288F | 0% | 308 | $0.00 | |
| G9899 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed | 0% | 33 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 43 | $0.00 |
| 4274F | 0% | 13 | $0.00 | |
| G9276 | Documentation that patient is a current tobacco user | 0% | 53 | $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 officialPRATHIPATI, KUMARA (PRESIDENT)