Physician
Prohealth Primary Care LLC
Prohealth Primary Care LLC was paid $5.42M by Medicaid between Oct 2019 and Dec 2024, across 53 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 40% of everything it billed.
33Billing provider infoPROHEALTH PRIMARY CARE LLC
ABERDEEN, MD 21001
ABERDEEN, MD 21001
33aNPI1982962692assigned 05/01/2012
33bProvider typeFamily Medicine Physician
28Total paid$5.42M
24GClaims100,416
24DCodes billed53
24AFirst – last monthOct 2019 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Maryland
Rank by total paid#5 of 287
Median peer was paid$78K
This provider vs. median69×
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 | |
|---|---|---|---|
| 2019 | 14 | $748.30 | |
| 2020 | 21,125 | $1.05M | |
| 2021 | 17,940 | $959K | |
| 2022 | 20,746 | $1.13M | |
| 2023 | 21,800 | $1.20M | |
| 2024incomplete | 18,791 | $1.08M |
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 | 40% | 26,527 | 21,987 | $2.16M |
| 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 | 23% | 10,813 | 9,545 | $1.26M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.4% | 3,312 | 3,137 | $345K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.6% | 3,017 | 2,783 | $306K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.5% | 3,192 | 2,752 | $299K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.3% | 2,093 | 1,926 | $235K |
| 99401 | 2.9% | 4,956 | 4,299 | $157K | |
| 96127 | 1.1% | 7,343 | 6,754 | $61K | |
| 90686 | <1% | 2,336 | 2,100 | $48K | |
| 90648 | <1% | 2,150 | 2,032 | $47K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 3,986 | 3,759 | $42K |
| 90670 | <1% | 1,792 | 1,708 | $40K |
41 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 3,289 | $38K |
| 90677 | <1% | 388 | $33K | |
| 90723 | <1% | 1,496 | $33K | |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | <1% | 35 | $31K |
| 92551 | <1% | 2,742 | $25K | |
| 90633 | <1% | 1,054 | $23K | |
| 90680 | <1% | 943 | $20K | |
| 90707 | <1% | 909 | $20K | |
| 90716 | <1% | 889 | $20K | |
| 90651 | <1% | 761 | $18K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 483 | $17K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 155 | $17K |
| 90700 | <1% | 710 | $15K | |
| 99381 | <1% | 169 | $14K | |
| 90734 | <1% | 565 | $13K | |
| 90688 | <1% | 513 | $11K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 37 | $10K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 739 | $9K |
| 96161 | <1% | 3,594 | $9K | |
| 99173 | <1% | 2,638 | $6K | |
| 96160 | <1% | 2,143 | $5K | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 478 | $5K |
| 90715 | <1% | 244 | $5K | |
| 90656 | <1% | 226 | $5K | |
| 99050 | <1% | 355 | $4K | |
| 90381 | <1% | 18 | $3K | |
| 90713 | <1% | 141 | $3K | |
| 92567 | <1% | 190 | $3K | |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | <1% | 167 | $2K |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 139 | $2K |
| 90619 | <1% | 38 | $2K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 13 | $1K |
| 90621 | <1% | 25 | $811.39 | |
| 90696 | <1% | 32 | $651.84 | |
| 94760 | <1% | 426 | $566.60 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 208 | $552.57 |
| 87807 | <1% | 40 | $435.90 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 29 | $372.65 |
| 84030 | <1% | 29 | $90.74 | |
| 99000 | <1% | 1,820 | $59.72 | |
| 36416 | 0% | 29 | $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 officialSUMILANG, NATHANIEL (PHYSICIAN/OWNER)