Physician
Michael L. Gambel M.D., P.C.
Michael L. Gambel M.D., P.C. was paid $5.20M by Medicaid between Jan 2018 and May 2022, across 90 billing codes. Its largest line is J2315, Injection, naltrexone, depot form, 1 mg — 69% of everything it billed.
33Billing provider infoMICHAEL L. GAMBEL M.D., P.C.
SOUTHGATE, MI 48195
SOUTHGATE, MI 48195
33aNPI1942458567assigned 09/08/2008
33bProvider typeFamily Medicine Physician
28Total paid$5.20M
24GClaims73,061
24DCodes billed90
24AFirst – last monthJan 2018 – May 2022
Compared with peers
Next to other Family Medicine Physician providers in Michigan
Rank by total paid#21 of 826
Median peer was paid$98K
This provider vs. median53×
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 | 15,255 | $1.74M | |
| 2019 | 19,345 | $1.26M | |
| 2020 | 17,926 | $1.07M | |
| 2021 | 15,368 | $874K | |
| 2022 | 5,167 | $261K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| J2315 | Injection, naltrexone, depot form, 1 mg | 69% | 3,122 | 2,866 | $3.61M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 22% | 20,072 | 16,645 | $1.13M |
| 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 | 3.4% | 2,261 | 2,158 | $177K |
| 80305 | 1.5% | 7,927 | 6,660 | $76K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 3,255 | 3,018 | $30K |
| 20610 | <1% | 671 | 580 | $29K | |
| 90682 | <1% | 540 | 537 | $24K | |
| 99442 | <1% | 525 | 500 | $18K | |
| 96127 | <1% | 3,280 | 3,230 | $18K | |
| 99205 | Prolong outpt/office vis | <1% | 90 | 84 | $12K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 292 | 286 | $10K |
| 99441 | <1% | 524 | 485 | $9K |
78 more codes
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 966 | $7K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 76 | $7K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 80 | $7K |
| 99406 | <1% | 706 | $6K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,847 | $4K |
| 99000 | <1% | 2,044 | $3K | |
| 99443 | <1% | 80 | $3K | |
| 90732 | <1% | 28 | $3K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 399 | $3K |
| 20552 | <1% | 115 | $3K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 25 | $2K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 862 | $2K |
| 90632 | <1% | 33 | $2K | |
| 90746 | <1% | 29 | $2K | |
| 82962 | <1% | 664 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 72 | $1K |
| 36416 | <1% | 428 | $1K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 14 | $1K |
| 96160 | <1% | 594 | $845.73 | |
| 94010 | <1% | 24 | $453.73 | |
| 90715 | <1% | 12 | $446.76 | |
| 92250 | <1% | 15 | $432.89 | |
| 81003 | <1% | 242 | $363.13 | |
| 90686 | <1% | 19 | $332.82 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | $180.28 |
| 99051 | <1% | 13 | $50.00 | |
| 82043 | <1% | 14 | $46.03 | |
| 82570 | <1% | 14 | $41.31 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 15 | $23.47 |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | <1% | 253 | $0.51 |
| G9007 | Coordinated care fee, scheduled team conference | <1% | 16 | $0.02 |
| 3080F | 0% | 1,196 | $0.00 | |
| 1036F | 0% | 122 | $0.00 | |
| 3079F | 0% | 2,745 | $0.00 | |
| 1111F | 0% | 131 | $0.00 | |
| 3074F | 0% | 5,182 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 108 | $0.00 |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 17 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 206 | $0.00 |
| G8732 | No documentation of pain assessment, reason not given | 0% | 290 | $0.00 |
| 3075F | 0% | 1,330 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 76 | $0.00 |
| G9717 | Documentation stating the patient has had a diagnosis of bipolar disorder | 0% | 282 | $0.00 |
| G8432 | Depression screening not documented, reason not given | 0% | 90 | $0.00 |
| G8952 | Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given | 0% | 13 | $0.00 |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 28 | $0.00 |
| 3017F | 0% | 76 | $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% | 42 | $0.00 |
| 3072F | 0% | 14 | $0.00 | |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 0% | 25 | $0.00 |
| G8926 | Spirometry test not performed or documented, reason not given | 0% | 29 | $0.00 |
| 98967 | 0% | 20 | $0.00 | |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 138 | $0.00 |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 0% | 14 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 34 | $0.00 |
| 3077F | 0% | 1,256 | $0.00 | |
| 3078F | 0% | 3,867 | $0.00 | |
| 3023F | 0% | 35 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 76 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 600 | $0.00 |
| 98966 | 0% | 100 | $0.00 | |
| G9744 | Patient not eligible due to active diagnosis of hypertension | 0% | 128 | $0.00 |
| 4004F | 0% | 38 | $0.00 | |
| 99072 | 0% | 1,477 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 17 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 92 | $0.00 |
| G9900 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified | 0% | 43 | $0.00 |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 83 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 14 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 320 | $0.00 |
| 2022F | 0% | 15 | $0.00 | |
| G8541 | Functional outcome assessment using a standardized tool not documented, reason not given | 0% | 314 | $0.00 |
| G8731 | Pain assessment using a standardized tool is documented as negative, no follow-up plan required | 0% | 13 | $0.00 |
| G9534 | Advanced brain imaging (cta, ct, mra or mri) was not ordered | 0% | 26 | $0.00 |
| G9636 | Health-related quality of life not assessed with tool during at least two visits or quality of life score declined | 0% | 12 | $0.00 |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 13 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 18 | $0.00 |
| G8539 | Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment | 0% | 25 | $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 officialGAMBEL, MICHAEL (OWNER/PRESIDENT)