Ghimire, Prajesh

Ghimire, Prajesh was paid $10K by Medicaid between Mar 2018 and Dec 2023, across 4 billing codes. Its largest line is 99233, hospital visit by a doctor, follow-up day (complex) — 76% of everything it billed.

33Billing provider infoGHIMIRE, PRAJESH
SARATOGA SPRINGS, NY 12866

33aNPI1821300401assigned 07/12/2010

33bProvider typeFamily Medicine Physician

28Total paid$10K

24GClaims714

24DCodes billed4

24AFirst – last monthMar 2018 – Dec 2023

Compared with peers

Next to other Family Medicine Physician providers in New York

Rank by total paid#1,341 of 2,605

Median peer was paid$10K

This provider vs. median0.9×

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	51	$623.18
2019	167	$3K
2020	219	$3K
2021	82	$770.27
2022	53	$748.19
2023	142	$2K

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	76%	567	254	$7K
99223	Prolong inpt eval add15 m	12%	39	39	$1K
99239	Hospital discharge day management, more than 30 minutes	9.7%	90	90	$919.92
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	2.5%	18	14	$234.09

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.