MARK RAPHAEL, DO
Gastroenterology Physician · SAGINAW, MI
Individual Active NPI 1922428382
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 364 | 777 | $263,258 | $95,535 | $75,342 |
| 2023 | 342 | 670 | $241,799 | $83,395 | $64,371 |
| 2022 | 371 | 736 | $268,036 | $95,191 | $74,713 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 138 | $78 | $59 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 107 | $125 | $99 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 86 | $125 | $102 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 82 | $75 | $59 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 61 | $235 | $194 |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 42 | $122 | $95 |
| 43235 | Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 40 | $95 | $75 |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 36 | $153 | $109 |
| 43249 | Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | 28 | $137 | $105 |
| 45378 | Diagnostic exam of large bowel using a flexible endoscope | 20 | $162 | $122 |
| 99221 | Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes | 18 | $79 | $60 |
| 43255 | Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 15 | $165 | $128 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ✓ | 5101020932 | MI |
| Internal Medicine Physician | 207R00000X | 5101020932 | MI |
Medicare eligibility
- Part B
- Yes
- DME
- Yes
- Home health
- Yes
- Power mobility
- Yes
- Hospice
- Yes
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.