DR Ajai J Agarwal MD PA

DR Ajai J Agarwal MD PA was paid $3.08M by Medicaid between Jan 2018 and Dec 2024, across 91 billing codes. Its largest line is 99222, Initial hospital care, per day, moderate complexity — 32% of everything it billed.

33Billing provider infoDR AJAI J AGARWAL MD PA
EL PASO, TX 79936

33aNPI1851423990assigned 03/12/2007

33bProvider typePreferred Provider Organization

28Total paid$3.08M

24GClaims136,578

24DCodes billed91

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Preferred Provider Organization providers in Texas

Rank by total paid#6 of 32

Median peer was paid$168K

This provider vs. median18×

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	11,469	$119K
2019	9,620	$115K
2020	16,846	$248K
2021	29,100	$654K
2022	25,961	$662K
2023	27,563	$684K
2024incomplete	16,019	$601K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99222	Initial hospital care, per day, moderate complexity	32%	9,516	8,977	$972K
99223	Prolong inpt eval add15 m	19%	4,547	4,247	$596K
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%	12,909	10,736	$536K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	10%	5,671	2,973	$322K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	7.8%	4,681	2,680	$240K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	4.3%	5,117	4,525	$132K
99236	Prolong inpt eval add15 m	3.0%	532	481	$92K
99235		<1%	220	202	$31K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	304	303	$21K
99350	Prolong home eval add 15m	<1%	632	573	$21K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	1,604	1,390	$19K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	180	180	$13K

79 more codes

80053	Comprehensive metabolic panel	<1%	1,840	$12K
80061	Lipid panel	<1%	1,635	$11K
99423		<1%	459	$9K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	1,616	$8K
83036	Hemoglobin; glycosylated (A1C)	<1%	1,038	$7K
99497		<1%	273	$6K
Q3014	Telehealth originating site facility fee	<1%	862	$5K
80305		<1%	509	$4K
93000		<1%	429	$3K
81002		<1%	1,746	$3K
99422		<1%	369	$3K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	223	$3K
99406		<1%	1,263	$2K
96125		<1%	64	$2K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	<1%	44	$2K
86328		<1%	34	$2K
99490	Ccm add 20min	<1%	157	$1K
36415	Collection of venous blood by venipuncture	<1%	3,797	$1K
82274		<1%	85	$568.11
3044F		<1%	1,132	$560.21
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	268	$436.96
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion	<1%	99	$357.90
87430		<1%	24	$225.40
J2930	Injection, methylprednisolone sodium succinate, up to 125 mg	<1%	42	$211.74
G0444	Annual depression screening, 5 to 15 minutes	<1%	229	$166.60
82043		<1%	73	$158.73
92551		<1%	27	$140.73
82570		<1%	71	$124.94
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	<1%	96	$100.31
99173		<1%	28	$96.00
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	25	$83.59
99421		<1%	13	$74.97
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	<1%	21	$50.00
83735		<1%	12	$48.69
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	13	$12.44
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	<1%	6,102	$1.03
G8754	Most recent diastolic blood pressure < 90 mmhg	<1%	6,694	$0.47
G8752	Most recent systolic blood pressure < 140 mmhg	<1%	5,392	$0.37
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	<1%	465	$0.18
G8510	Screening for depression is documented as negative, a follow-up plan is not required	<1%	526	$0.08
G8753	Most recent systolic blood pressure >= 140 mmhg	<1%	1,626	$0.07
1126F		<1%	5,027	$0.06
2000F		<1%	16,554	$0.06
G9622	Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method	<1%	255	$0.05
3008F		<1%	10,510	$0.05
1160F		<1%	1,530	$0.04
1159F		<1%	359	$0.03
G9903	Patient screened for tobacco use and identified as a tobacco non-user	<1%	167	$0.03
G8731	Pain assessment using a standardized tool is documented as negative, no follow-up plan required	<1%	193	$0.02
G8734	Elder maltreatment screen documented as negative, follow-up is not required	<1%	184	$0.01
3288F		0%	1,536	$0.00
1494F		0%	1,294	$0.00
3077F		0%	132	$0.00
1090F		0%	1,600	$0.00
3078F		0%	1,274	$0.00
1124F		0%	1,167	$0.00
G0179	Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	0%	12	$0.00
99072		0%	3,401	$0.00
3050F		0%	29	$0.00
G8730	Pain assessment documented as positive using a standardized tool and a follow-up plan is documented	0%	19	$0.00
G8484	Influenza immunization was not administered, reason not given	0%	166	$0.00
3016F		0%	234	$0.00
1125F		0%	94	$0.00
1006F		0%	316	$0.00
3048F		0%	767	$0.00
G8755	Most recent diastolic blood pressure >= 90 mmhg	0%	434	$0.00
1101F		0%	1,533	$0.00
3074F		0%	1,249	$0.00
3075F		0%	349	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	67	$0.00
3080F		0%	93	$0.00
3079F		0%	342	$0.00
1123F		0%	70	$0.00
G0480	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; 1-7 drug class(es), including metabolite(s) if performed	0%	21	$0.00
G0008	Administration of influenza virus vaccine	0%	25	$0.00
3049F		0%	98	$0.00
82962		0%	42	$0.00
3017F		0%	86	$0.00
G8432	Depression screening not documented, reason not given	0%	15	$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 officialAGARWAL, AJAI (OWNER)