Western Mass Physician Associates INC

Western Mass Physician Associates INC was paid $5.68M by Medicaid between Jan 2018 and Dec 2024, across 80 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 39% of everything it billed.

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	26,685	$898K
2019	27,086	$901K
2020	23,772	$962K
2021	23,359	$1.09M
2022	22,038	$1.07M
2023	24,852	$505K
2024incomplete	19,238	$252K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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%	62,404	58,654	$2.24M
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	38%	46,459	43,911	$2.13M
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	4.4%	3,914	3,804	$250K
90460	Immunization administration through 18 years of age via any route, first or only component	2.3%	5,036	5,015	$128K
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	1.6%	1,540	415	$91K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	1.6%	1,557	1,555	$91K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	1.3%	1,505	1,503	$75K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	1.3%	1,124	1,118	$71K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	1.2%	960	937	$70K
96110	Developmental screening, with scoring and documentation, per standardized instrument	1.1%	5,675	5,654	$60K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	3,522	3,483	$52K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	764	764	$41K

68 more codes

S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	<1%	4,408	$38K
83036	Hemoglobin; glycosylated (A1C)	<1%	8,600	$34K
G0299	Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes	<1%	395	$30K
99173		<1%	1,947	$27K
90686		<1%	2,967	$26K
99397		<1%	227	$25K
99203	Doctor's office visit, new patient (routine)	<1%	243	$18K
92551		<1%	1,858	$17K
99443		<1%	476	$14K
99442		<1%	611	$12K
99460		<1%	124	$12K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	594	$11K
99215	Doctor's office visit, returning patient (complex)	<1%	258	$11K
99222	Initial hospital care, per day, moderate complexity	<1%	207	$9K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	569	$9K
90688		<1%	751	$9K
81025		<1%	1,328	$8K
G0444	Annual depression screening, 5 to 15 minutes	<1%	850	$8K
96127		<1%	700	$6K
99238	Hospital discharge day management, 30 minutes or less	<1%	89	$5K
99385		<1%	44	$4K
99188		<1%	161	$4K
99462		<1%	79	$3K
95165	Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials	<1%	99	$3K
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%	828	$3K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed	<1%	69	$3K
90662		<1%	246	$2K
0072A		<1%	51	$2K
0071A		<1%	50	$2K
90677		<1%	15	$2K
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	<1%	58	$2K
90715		<1%	65	$2K
99204	Doctor's office visit, new patient (more involved)	<1%	24	$2K
90732		<1%	66	$1K
99386		<1%	14	$1K
G0008	Administration of influenza virus vaccine	<1%	1,207	$1K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	102	$1K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	88	$938.04
81003		<1%	627	$795.67
95117		<1%	76	$648.00
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	31	$645.67
90682		<1%	22	$555.49
90480		<1%	12	$522.92
99221		<1%	15	$494.03
S3005	Performance measurement, evaluation of patient self assessment, depression	<1%	50	$431.35
80305		<1%	35	$257.34
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	20	$244.52
85018		<1%	107	$214.80
99051		<1%	12	$196.24
90670		<1%	88	$183.52
96160		<1%	254	$122.26
G0009	Administration of pneumococcal vaccine	<1%	12	$112.00
87210		<1%	26	$98.17
86580		<1%	12	$75.60
81002		<1%	14	$30.84
90716		0%	12	$0.00
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	0%	183	$0.00
90651		0%	61	$0.00
90647		0%	52	$0.00
90680		0%	26	$0.00
90697		0%	12	$0.00
99406		0%	13	$0.00
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	0%	126	$0.00
G0438	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	0%	70	$0.00
90685		0%	17	$0.00
90734		0%	40	$0.00
90633		0%	26	$0.00
Q2038	Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)	0%	51	$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 officialCANDITO, PHILLIP (VP OF AMBULATORY SERVICES)

Parent organizationVALLEY HEALTH SYSTEMS, INC.