Physician
Mid-Atlantic Pain Institute, P.A.
Mid-Atlantic Pain Institute, P.A. was paid $959K by Medicaid between Jan 2018 and Aug 2022, across 46 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 53% of everything it billed.
33Billing provider infoMID-ATLANTIC PAIN INSTITUTE, P.A.
NEWARK, DE 19702
NEWARK, DE 19702
33aNPI1831148410assigned 05/09/2006
33bProvider typeInterventional Pain Medicine Physician
28Total paid$959K
24GClaims174,068
24DCodes billed46
24AFirst – last monthJan 2018 – Aug 2022
Compared with peers
Next to other Interventional Pain Medicine Physician providers in Delaware
Rank by total paid#1 of 5
Median peer was paid$8K
This provider vs. median122×
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 | 63,552 | $220K | |
| 2019 | 97,384 | $278K | |
| 2020 | 7,824 | $206K | |
| 2021 | 3,957 | $171K | |
| 2022 | 1,351 | $83K |
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 | 53% | 19,742 | 12,259 | $512K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 20% | 6,149 | 4,227 | $194K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | 20% | 4,224 | 3,507 | $191K |
| 99406 | 1.2% | 3,162 | 2,335 | $12K | |
| 95923 | <1% | 142 | 120 | $9K | |
| 96138 | <1% | 901 | 508 | $8K | |
| 93922 | <1% | 127 | 108 | $6K | |
| 95886 | <1% | 193 | 154 | $5K | |
| 95921 | <1% | 143 | 121 | $5K | |
| 95911 | <1% | 26 | 24 | $3K | |
| 76942 | <1% | 327 | 210 | $3K | |
| 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% | 224 | 163 | $3K |
34 more codes
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 155 | $2K |
| 62370 | <1% | 109 | $2K | |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | <1% | 13,111 | $1K |
| 96103 | <1% | 1,970 | $875.68 | |
| 80305 | <1% | 602 | $865.17 | |
| 95913 | <1% | 119 | $752.78 | |
| 20553 | <1% | 62 | $525.03 | |
| G9578 | Documentation of signed opioid treatment agreement at least once during opioid therapy | <1% | 2,130 | $517.00 |
| 4004F | <1% | 6,742 | $291.58 | |
| 96127 | <1% | 98 | $257.11 | |
| 96101 | <1% | 195 | $245.89 | |
| 93000 | <1% | 176 | $237.51 | |
| G9584 | Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy | <1% | 12,983 | $40.71 |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | <1% | 77 | $24.22 |
| S0020 | Injection, bupivicaine hydrochloride, 30 ml | <1% | 68 | $9.52 |
| 99000 | <1% | 64 | $4.50 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 15,138 | $0.00 |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 14,689 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 1,604 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 12,643 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 12,006 | $0.00 |
| G8731 | Pain assessment using a standardized tool is documented as negative, no follow-up plan required | 0% | 19 | $0.00 |
| A4550 | Surgical trays | 0% | 115 | $0.00 |
| G8400 | Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given | 0% | 37 | $0.00 |
| A4220 | Refill kit for implantable infusion pump | 0% | 37 | $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% | 4,822 | $0.00 |
| G9583 | Patients prescribed opiates for longer than six weeks | 0% | 12,264 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 2,563 | $0.00 |
| 1036F | 0% | 8,563 | $0.00 | |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 5,431 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 7,375 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 2,167 | $0.00 |
| 1006F | 0% | 554 | $0.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 20 | $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 officialFALCO, FRANK (MEDICAL DIRECTOR)