Physician
Sanford Medical Care, PLLC
Sanford Medical Care, PLLC was paid $1.27M by Medicaid between Jan 2018 and Nov 2024, across 21 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 44% of everything it billed.
33Billing provider infoSANFORD MEDICAL CARE, PLLC
FLUSHING, NY 11355
FLUSHING, NY 11355
33aNPI1891163937assigned 09/07/2015
33bProvider typeAnesthesiology Physician
28Total paid$1.27M
24GClaims16,282
24DCodes billed21
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Anesthesiology Physician providers in New York
Rank by total paid#25 of 493
Median peer was paid$8K
This provider vs. median165×
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 | 853 | $133K | |
| 2019 | 2,341 | $215K | |
| 2020 | 3,609 | $149K | |
| 2021 | 4,749 | $263K | |
| 2022 | 2,625 | $200K | |
| 2023 | 1,213 | $179K | |
| 2024incomplete | 892 | $130K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 44% | 2,180 | 2,164 | $560K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 2,669 | 2,634 | $236K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 15% | 1,539 | 1,538 | $184K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 12% | 705 | 694 | $150K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 6.9% | 246 | 245 | $88K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.9% | 441 | 425 | $24K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 1.5% | 68 | 67 | $19K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 114 | 112 | $6K |
| 88312 | <1% | 14 | 14 | $566.74 | |
| 88313 | <1% | 14 | 14 | $424.84 | |
| 3074F | <1% | 70 | 70 | $99.00 | |
| 3078F | <1% | 60 | 60 | $63.00 |
9 more codes
| 3017F | 0% | 1,035 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 932 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 1,827 | $0.00 |
| G8430 | Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status) | 0% | 143 | $0.00 |
| 1036F | 0% | 1,224 | $0.00 | |
| 99000 | 0% | 451 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 1,615 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 543 | $0.00 |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 392 | $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 officialCHUANG, CHE-NAN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Sanford Endoscopy PLLC | Flushing, NY | $76K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.