Cornerstone Pulmonary and Critical Care Associates, PLLC

Cornerstone Pulmonary and Critical Care Associates, PLLC was paid $85K by Medicaid between Jan 2018 and Dec 2024, across 24 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 64% of everything it billed.

33Billing provider infoCORNERSTONE PULMONARY AND CRITICAL CARE ASSOCIATES, PLLC
LEBANON, TN 37087

33aNPI1932112620assigned 08/14/2006

33bProvider typePulmonary Disease Physician

28Total paid$85K

24GClaims25,466

24DCodes billed24

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pulmonary Disease Physician providers in Tennessee

Rank by total paid#20 of 62

Median peer was paid$26K

This provider vs. median3.2×

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	4,227	$15K
2019	4,769	$12K
2020	3,385	$10K
2021	3,513	$13K
2022	3,844	$12K
2023	3,215	$12K
2024incomplete	2,513	$11K

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	64%	2,363	2,090	$54K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	25%	1,381	1,286	$21K
94060		3.4%	169	152	$3K
94729		3.3%	196	179	$3K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	2.3%	161	54	$2K
94726		2.0%	105	97	$2K
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	42	26	$552.98
G0296	Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)	<1%	29	26	$135.75
G9432	Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented	0%	226	204	$0.00
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	705	629	$0.00
G9906	Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)	0%	666	619	$0.00
G8924	Spirometry results documented (fev1/fvc < 70%)	0%	879	769	$0.00

12 more codes

1036F		0%	1,570	$0.00
G9902	Patient screened for tobacco use and identified as a tobacco user	0%	947	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	378	$0.00
G9521	Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months	0%	255	$0.00
G8422	Bmi not documented, documentation the patient is not eligible for bmi calculation	0%	35	$0.00
G9744	Patient not eligible due to active diagnosis of hypertension	0%	2,298	$0.00
3023F		0%	1,520	$0.00
4004F		0%	887	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	3,149	$0.00
G9695	Long-acting inhaled bronchodilator prescribed	0%	2,726	$0.00
G8783	Normal blood pressure reading documented, follow-up not required	0%	1,520	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	3,259	$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 officialKEHINDE, MODUPE (SOLE MEMBER)