Managed care
Michael J Spezia DO INC
Michael J Spezia DO INC was paid $436K by Medicaid between Jan 2018 and Nov 2024, across 34 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 54% of everything it billed.
33Billing provider infoMICHAEL J SPEZIA DO INC
SAINT LOUIS, MO 63121
SAINT LOUIS, MO 63121
33aNPI1912229147assigned 02/15/2010
33bProvider typeHealth Maintenance Organization
28Total paid$436K
24GClaims28,470
24DCodes billed34
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Health Maintenance Organization providers in Missouri
Rank by total paid#7 of 12
Median peer was paid$436K
This provider vs. median1.0×
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 | 3,102 | $42K | |
| 2019 | 2,299 | $34K | |
| 2020 | 1,296 | $42K | |
| 2021 | 1,490 | $48K | |
| 2022 | 1,804 | $66K | |
| 2023 | 8,729 | $118K | |
| 2024incomplete | 9,750 | $86K |
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 | 54% | 5,234 | 4,188 | $236K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 39% | 5,312 | 4,663 | $172K |
| 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 | 2.5% | 95 | 86 | $11K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.5% | 288 | 242 | $6K |
| 99497 | <1% | 657 | 479 | $4K | |
| 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% | 26 | 24 | $2K |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | <1% | 902 | 600 | $2K |
| 99406 | <1% | 146 | 121 | $1K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 37 | 19 | $987.25 |
| 99221 | <1% | 29 | 26 | $816.08 | |
| 81000 | <1% | 122 | 88 | $163.35 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 53 | 52 | $132.10 |
22 more codes
| 86580 | <1% | 19 | $68.38 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 95 | $26.40 |
| 3074F | <1% | 1,806 | $20.00 | |
| 3075F | <1% | 1,066 | $10.00 | |
| 3079F | <1% | 379 | $10.00 | |
| 3078F | <1% | 2,557 | $10.00 | |
| 99442 | <1% | 16 | $5.57 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 1,275 | $0.00 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 678 | $0.00 |
| 3044F | 0% | 315 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 984 | $0.00 |
| 1034F | 0% | 32 | $0.00 | |
| 90688 | 0% | 15 | $0.00 | |
| 1170F | 0% | 22 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 2,456 | $0.00 |
| G8476 | Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg | 0% | 1,380 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 1,559 | $0.00 |
| 3288F | 0% | 250 | $0.00 | |
| 3077F | 0% | 66 | $0.00 | |
| G8477 | Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg | 0% | 65 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 519 | $0.00 |
| 90756 | 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 officialSPEZIA, MICHAEL (DOCTOR)