Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Pratt Medical Group, INC

Pratt Medical Group, INC was paid $69K by Medicaid between Jan 2018 and Oct 2024, across 7 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 77% of everything it billed.

33Billing provider infoPRATT MEDICAL GROUP, INC
BOSTON, MA 02111
33aNPI1871814913assigned 06/11/2010
33bProvider typeRheumatology Physician
28Total paid$69K
24GClaims2,631
24DCodes billed7
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers

Next to other Rheumatology Physician providers in Massachusetts

Rank by total paid#11 of 46
Median peer was paid$12K
This provider vs. median5.5×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official GALLEGOS, EDWARD controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$2.0K$4.0K$6.0K2018201920202021202220232024
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
YearClaimsPaid
20181,056$27K
2019771$19K
2020157$5K
2021168$6K
2022245$7K
2023143$3K
2024incomplete91$2K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 77% 1,984 1,933 $53K
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% 580 573 $14K
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 1.8% 14 14 $1K
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis <1% 12 12 $355.25
20610 <1% 14 14 $334.21
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 13 12 $18.50
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) 0% 14 14 $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 officialGALLEGOS, EDWARD (DIRECTOR)
Same official

Other billing entities under GALLEGOS, EDWARD

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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.