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

Evans Medical Foundation, INC.

Evans Medical Foundation, INC. was paid $37.72M by Medicaid between Jan 2018 and Dec 2024, across 116 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 30% of everything it billed.

33Billing provider infoEVANS MEDICAL FOUNDATION, INC.
BOSTON, MA 02118
33aNPI1912954124assigned 05/31/2006
33bProvider typeGastroenterology Physician
28Total paid$37.72M
24GClaims1,162,281
24DCodes billed116
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Gastroenterology Physician providers in Massachusetts

Rank by total paid#1 of 71
Median peer was paid$11K
This provider vs. median3,393×

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

$0$250K$500K$750K2018201920202021202220232024
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
2018156,615$5.16M
2019167,021$5.41M
2020148,954$5.15M
2021162,501$5.46M
2022175,462$6.15M
2023188,704$5.66M
2024incomplete163,024$4.73M
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 30% 283,637 275,287 $11.32M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 16% 127,034 50,920 $6.16M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 9.5% 34,706 16,157 $3.59M
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 7.8% 89,428 38,477 $2.96M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5.7% 74,705 73,150 $2.15M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 5.6% 38,783 36,363 $2.10M
99223 Prolong inpt eval add15 m 3.9% 15,240 14,940 $1.46M
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 3.8% 296,268 220,654 $1.44M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3.3% 36,378 36,079 $1.24M
99239 Hospital discharge day management, more than 30 minutes 1.7% 12,647 12,387 $645K
99222 Initial hospital care, per day, moderate complexity 1.3% 7,520 7,354 $479K
99220 1.2% 4,865 4,836 $445K
104 more codes
99204 Doctor's office visit, new patient (more involved) <1% 4,600 $375K
90961 <1% 3,916 $315K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits <1% 3,385 $312K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 13,551 $196K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 2,188 $173K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 8,755 $159K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 1,211 $157K
99350 Prolong home eval add 15m <1% 5,051 $148K
99205 Prolong outpt/office vis <1% 1,125 $129K
99217 <1% 3,087 $117K
99443 <1% 6,102 $107K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 875 $91K
99219 <1% 1,200 $85K
99407 <1% 2,619 $83K
99238 Hospital discharge day management, 30 minutes or less <1% 2,157 $79K
99310 Prolong nursin fac eval 15m <1% 3,675 $72K
99221 <1% 1,361 $64K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 854 $58K
99442 <1% 5,046 $57K
20610 <1% 2,733 $56K
93351 <1% 1,067 $55K
99292 <1% 908 $52K
93272 <1% 2,980 $44K
76536 <1% 2,845 $44K
93971 <1% 3,029 $35K
77080 <1% 8,816 $35K
43235 <1% 498 $33K
91200 <1% 3,910 $33K
99203 Doctor's office visit, new patient (routine) <1% 651 $32K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 382 $32K
94726 <1% 4,906 $31K
99226 <1% 526 $30K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 662 $28K
94060 <1% 3,625 $24K
93016 <1% 1,689 $24K
93970 <1% 1,368 $24K
99349 <1% 1,011 $23K
94729 <1% 4,726 $22K
95811 <1% 334 $22K
99306 Prolong nursin fac eval 15m <1% 575 $20K
90966 <1% 185 $18K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 400 $18K
90962 <1% 245 $18K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 735 $17K
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% 4,616 $16K
G0318 Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes) <1% 420 $15K
90935 Hemodialysis procedure with single evaluation by a physician <1% 523 $14K
93295 <1% 872 $14K
93298 <1% 1,045 $10K
93227 <1% 530 $9K
93321 <1% 1,937 $8K
93923 <1% 797 $7K
94010 <1% 1,470 $7K
93294 <1% 750 $7K
93280 <1% 479 $6K
93880 <1% 312 $6K
93308 <1% 475 $6K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 67 $5K
99441 <1% 747 $4K
93325 <1% 2,177 $4K
93228 <1% 462 $3K
99348 <1% 117 $3K
93018 <1% 351 $3K
99236 Prolong inpt eval add15 m <1% 25 $3K
G0008 Administration of influenza virus vaccine <1% 480 $2K
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care <1% 212 $2K
99225 <1% 62 $2K
20611 <1% 104 $2K
90662 <1% 323 $2K
76604 <1% 132 $2K
90694 <1% 118 $2K
99201 <1% 74 $2K
98941 Chiropractic manipulative treatment; spinal, 3-4 regions <1% 86 $2K
94618 <1% 133 $2K
99417 Prolong home eval add 15m <1% 30 $1K
99402 <1% 43 $1K
99356 <1% 294 $1K
99497 <1% 74 $1K
93282 <1% 53 $931.80
76377 <1% 42 $922.40
91322 <1% 57 $813.12
90480 <1% 57 $761.32
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) <1% 37 $661.85
90653 <1% 54 $558.00
91010 <1% 13 $557.09
20605 <1% 34 $503.26
76937 <1% 60 $386.37
11721 <1% 26 $370.45
76376 <1% 70 $370.38
93284 <1% 14 $355.77
99152 <1% 182 $310.28
99451 <1% 12 $290.74
93289 <1% 16 $285.61
91065 <1% 36 $206.61
99316 <1% 15 $193.87
36410 <1% 38 $168.44
99358 Prolong nursin fac eval 15m <1% 16 $156.92
95251 <1% 12 $135.67
99318 <1% 31 $76.07
93922 <1% 13 $47.92
99337 <1% 21 $19.50
Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) <1% 22 $12.44
99153 Mod sedat endo service >5yrs <1% 15 $10.79
M1207 Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety 0% 223 $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 officialWAIKAR, SUSHRUT (INTERIM PRESIDENT)