Physician
Pulmonary & Critical Care Consultants, INC
Pulmonary & Critical Care Consultants, INC was paid $1.85M by Medicaid between Jan 2018 and Nov 2024, across 20 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 58% of everything it billed.
33Billing provider infoPULMONARY & CRITICAL CARE CONSULTANTS, INC
DAYTON, OH 45409
DAYTON, OH 45409
33aNPI1861432379assigned 06/07/2006
33bProvider typeCritical Care Medicine (Internal Medicine) Physician
28Total paid$1.85M
24GClaims50,377
24DCodes billed20
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Critical Care Medicine (Internal Medicine) Physician providers in Ohio
Rank by total paid#2 of 31
Median peer was paid$60K
This provider vs. median31×
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 | 6,679 | $245K | |
| 2019 | 6,203 | $233K | |
| 2020 | 7,547 | $298K | |
| 2021 | 8,595 | $321K | |
| 2022 | 7,940 | $288K | |
| 2023 | 8,415 | $257K | |
| 2024incomplete | 4,998 | $205K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 58% | 20,652 | 8,441 | $1.07M |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 19% | 12,862 | 6,645 | $351K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 7.2% | 6,874 | 3,524 | $133K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.4% | 5,048 | 4,785 | $101K |
| 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 | 4.6% | 2,383 | 2,151 | $84K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 2.7% | 811 | 774 | $49K |
| 99243 | 1.3% | 751 | 716 | $23K | |
| 95811 | 1.2% | 347 | 327 | $22K | |
| 36556 | <1% | 162 | 127 | $5K | |
| 94060 | <1% | 113 | 95 | $1K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 46 | 40 | $1K |
| 99255 | <1% | 12 | 12 | $1K |
8 more codes
| 31500 | <1% | 12 | $872.84 | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 108 | $759.08 |
| 99292 | <1% | 23 | $611.13 | |
| 36620 | <1% | 14 | $295.05 | |
| 76937 | <1% | 32 | $242.31 | |
| 94729 | <1% | 55 | $239.17 | |
| 94726 | <1% | 44 | $164.91 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 28 | $3.18 |
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 officialHOLBERT, SHAUNNA (OPERATIONS MANAGER)