CHARLES ANDREW JORDAN, MD
NPI 1083784235, individual, Lebanon, TN, Pediatrics
- Hours beyond a day in 2 months, but with up to 1300 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 90460 ($54 per patient-month) sit in the top 5% of every provider billing that code.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Nov 2019 | More hours than a day holds at a conservative unit price | 22.7 | 36.2 | 24.1 | 34.5 | 1258 | 1 | 99203 99212 99213 99214 99238 | $87K |
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 24.2 | 38.1 | 25.4 | 35.7 | 1300 | 1 | 99203 99212 99213 99214 99215 | $93K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CHARLES ANDREW JORDAN, MD |
| Type | Individual |
| Status | Active |
| NPI issued | November 8, 2006, last updated September 7, 2012 |
| Practice location | 1029 W MAIN ST, SUITE M, Lebanon, TN 37087-3351, 615-453-1252 |
| Specialties | Pediatrics (208000000X, primary, license MD019767 TN) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.3M | 21% | $76 | $60 (top 5% from $133) | 67th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.2M | 19% | $51 | $44 (top 5% from $110) | 60th percentile | |
| 90460 | Administration of first vaccine or toxoid component with counseling (18 years or younger) | $672K | 11% | $54 | $26 (top 5% from $54) | 95th percentile | |
| 99392 | Medicaid service code | $507K | 8% | $76 | $78 (top 5% from $124) | 46th percentile | |
| 96110 | Medicaid service code | $430K | 7% | $26 | $10 (top 5% from $38) | 90th percentile | |
| 99393 | Medicaid service code | $409K | 7% | $75 | $78 (top 5% from $121) | 46th percentile | |
| 99391 | Medicaid service code | $388K | 6% | $68 | $76 (top 5% from $126) | 37th percentile | |
| 99394 | Medicaid service code | $236K | 4% | $86 | $83 (top 5% from $128) | 55th percentile |
In this area
2 providers in Wilson County, TN carry an indicator in the public record, with $3.0M at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | MT JULIET HEALTH CARE CENTER LLC Mount Juliet, TN, ranked 4062 | $0 |
|
| 4 | IRENE BIBLE Lebanon, TN, ranked 8553 | $3.0M |
|
Recent enforcement in TN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.