SM Medical, LLC

SM Medical, LLC was paid $4.98M by Medicaid between Jan 2018 and Nov 2024, across 75 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 19% of everything it billed.

33Billing provider infoSM MEDICAL, LLC
BLOOMFIELD, NJ 07003

33aNPI1932562907assigned 03/29/2016

33bProvider typeInternal Medicine Physician

28Total paid$4.98M

24GClaims229,949

24DCodes billed75

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Internal Medicine Physician providers in New Jersey

Rank by total paid#16 of 1,027

Median peer was paid$30K

This provider vs. median167×

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	25,058	$568K
2019	25,050	$648K
2020	29,194	$715K
2021	31,435	$771K
2022	36,000	$769K
2023	40,797	$831K
2024incomplete	42,415	$674K

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	19%	23,660	18,209	$963K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	19%	29,024	7,009	$961K
99310	Prolong nursin fac eval 15m	19%	14,315	3,939	$950K
99309	Subsequent nursing facility care, per day, low to moderate complexity	7.7%	27,077	8,434	$383K
J0696	Injection, ceftriaxone sodium, per 250 mg	6.3%	2,875	2,591	$316K
99401		5.7%	13,198	10,882	$282K
99223	Prolong inpt eval add15 m	4.7%	4,471	3,964	$235K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	2.3%	3,465	3,084	$116K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	2.2%	11,088	9,634	$110K
99239	Hospital discharge day management, more than 30 minutes	2.1%	3,247	2,911	$103K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	1.4%	6,512	1,310	$69K
J1040	Injection, methylprednisolone acetate, 80 mg	1.3%	4,400	3,865	$65K

63 more codes

99308	Subsequent nursing facility care, per day, straightforward	1.2%	3,237	$59K
99306	Prolong nursin fac eval 15m	1.1%	1,259	$56K
93922		1.0%	2,375	$52K
93000		<1%	3,100	$33K
99254		<1%	187	$29K
92540		<1%	733	$20K
92546		<1%	724	$18K
G0444	Annual depression screening, 5 to 15 minutes	<1%	2,223	$17K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	263	$15K
G0442	Annual alcohol misuse screening, 5 to 15 minutes	<1%	2,739	$13K
99204	Doctor's office visit, new patient (more involved)	<1%	178	$13K
93306	Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete	<1%	262	$12K
J3420	Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	<1%	6,661	$8K
99347		<1%	208	$7K
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	5,147	$7K
99215	Doctor's office visit, returning patient (complex)	<1%	124	$7K
92537		<1%	792	$6K
93925		<1%	129	$6K
93880		<1%	194	$6K
99336		<1%	88	$5K
93970		<1%	145	$5K
90756		<1%	278	$4K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	358	$4K
90674		<1%	226	$4K
J1010	Injection, methylprednisolone acetate, 1 mg	<1%	268	$4K
99349		<1%	85	$4K
99354		<1%	78	$3K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	14	$1K
99335		<1%	33	$1K
99222	Initial hospital care, per day, moderate complexity	<1%	39	$1K
99220		<1%	15	$769.32
99496		<1%	13	$656.98
99316		<1%	32	$458.77
99348		<1%	13	$401.56
99326		<1%	23	$378.92
99334		<1%	16	$371.39
99490	Ccm add 20min	<1%	300	$282.87
90688		<1%	17	$262.55
82962		<1%	451	$170.14
G0008	Administration of influenza virus vaccine	<1%	130	$148.28
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	<1%	70	$91.31
99072		<1%	1,036	$17.50
4004F		0%	201	$0.00
3077F		0%	1,767	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	8,404	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	0%	4,133	$0.00
G8753	Most recent systolic blood pressure >= 140 mmhg	0%	2,508	$0.00
3078F		0%	4,583	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	431	$0.00
G0030	Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user	0%	67	$0.00
4040F		0%	29	$0.00
3008F		0%	12,669	$0.00
3079F		0%	1,756	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	5,058	$0.00
3074F		0%	4,306	$0.00
3080F		0%	1,169	$0.00
1036F		0%	1,416	$0.00
G8755	Most recent diastolic blood pressure >= 90 mmhg	0%	1,542	$0.00
3075F		0%	1,379	$0.00
G9231	Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period	0%	298	$0.00
3044F		0%	555	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	0%	14	$0.00
3014F		0%	69	$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 officialSAMUEL, RAMEZ (CO-OWNER)