Physician
Functional Healthcare PC
Functional Healthcare PC was paid $3K by Medicaid between Jan 2018 and Jul 2021, across 7 billing codes. Its largest line is 95831, — 46% of everything it billed.
33Billing provider infoFUNCTIONAL HEALTHCARE PC
MARLBORO, NJ 07746
MARLBORO, NJ 07746
33aNPI1912337312assigned 11/21/2013
33bProvider typeNeurological Surgery Physician
28Total paid$3K
24GClaims1,188
24DCodes billed7
24AFirst – last monthJan 2018 – Jul 2021
Compared with peers
Next to other Neurological Surgery Physician providers in New Jersey
Rank by total paid#14 of 16
Median peer was paid$10K
This provider vs. median0.3×
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 | 105 | $2K | |
| 2019 | 547 | $605.99 | |
| 2020 | 291 | $319.72 | |
| 2021 | 245 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 95831 | 46% | 60 | 60 | $1K | |
| 99358 | Prolong nursin fac eval 15m | 29% | 636 | 628 | $839.77 |
| 97750 | 20% | 358 | 190 | $590.97 | |
| 95851 | 4.6% | 14 | 14 | $134.52 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 53 | 53 | $1.80 |
| 96160 | 0% | 34 | 34 | $0.00 | |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | 0% | 33 | 33 | $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 officialSHAH, NILAY (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Medical Diagnostic Services PC | Tarrytown, NY | $279K |
| Nilay Shah MD PC | Maywood, NJ | $254K |
| Preston Smiles PLLC | Dallas, TX | $36K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.