Physician
Spectrum Medical Group PA
Spectrum Medical Group PA was paid $388K by Medicaid between Jan 2018 and Dec 2024, across 43 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 45% of everything it billed.
33Billing provider infoSPECTRUM MEDICAL GROUP PA
WINSTON-SALEM, NC 27103
WINSTON-SALEM, NC 27103
33aNPI1801878632assigned 11/17/2005
33bProvider typePulmonary Disease Physician
28Total paid$388K
24GClaims21,506
24DCodes billed43
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in North Carolina
Rank by total paid#5 of 34
Median peer was paid$82K
This provider vs. median4.7×
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 | 3,283 | $33K | |
| 2019 | 2,371 | $61K | |
| 2020 | 2,565 | $100K | |
| 2021 | 3,374 | $72K | |
| 2022 | 1,836 | $30K | |
| 2023 | 3,548 | $36K | |
| 2024incomplete | 4,529 | $56K |
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 | 45% | 4,404 | 3,825 | $173K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 38% | 1,263 | 501 | $146K |
| 94010 | 7.9% | 3,072 | 2,614 | $31K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.2% | 188 | 83 | $8K |
| 94729 | 2.1% | 699 | 586 | $8K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.7% | 231 | 190 | $7K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 548 | 495 | $4K |
| 99406 | <1% | 360 | 318 | $2K | |
| 99205 | Prolong outpt/office vis | <1% | 24 | 24 | $2K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 28 | 26 | $2K |
| 94727 | <1% | 131 | 122 | $1K | |
| 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% | 19 | 16 | $1K |
31 more codes
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 30 | $1K |
| 99223 | Prolong inpt eval add15 m | <1% | 13 | $1K |
| 94664 | <1% | 113 | $436.87 | |
| 3017F | 0% | 1,307 | $0.00 | |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 306 | $0.00 |
| G8732 | No documentation of pain assessment, reason not given | 0% | 589 | $0.00 |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 109 | $0.00 |
| G8432 | Depression screening not documented, reason not given | 0% | 838 | $0.00 |
| 1036F | 0% | 470 | $0.00 | |
| G9717 | Documentation stating the patient has had a diagnosis of bipolar disorder | 0% | 184 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 681 | $0.00 |
| 3074F | 0% | 196 | $0.00 | |
| 1101F | 0% | 135 | $0.00 | |
| 1123F | 0% | 133 | $0.00 | |
| G0296 | Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) | 0% | 16 | $0.00 |
| G8926 | Spirometry test not performed or documented, reason not given | 0% | 25 | $0.00 |
| G8536 | No documentation of an elder maltreatment screen, reason not given | 0% | 123 | $0.00 |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 12 | $0.00 |
| G9906 | Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) | 0% | 12 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 2,868 | $0.00 |
| G8541 | Functional outcome assessment using a standardized tool not documented, reason not given | 0% | 939 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 215 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 255 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 180 | $0.00 |
| 3023F | 0% | 72 | $0.00 | |
| 4004F | 0% | 12 | $0.00 | |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 29 | $0.00 |
| 3078F | 0% | 357 | $0.00 | |
| 4040F | 0% | 134 | $0.00 | |
| G9899 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed | 0% | 143 | $0.00 |
| 1090F | 0% | 43 | $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 officialFERRELL, TAMMY (ADMINISTRATOR)