JOHN L HERZOG, MD
NPI 1093734949, individual, Greenville, MS, Internal Medicine, Cardiovascular Disease
- Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 24.2 | 15.0 | 10.0 | 14.1 | 339 | 1 | 99213 99214 99223 99232 99233 99238 | $19K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JOHN L HERZOG, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | July 19, 2006, last updated August 21, 2020 |
| Practice location | 1421 E UNION ST, Greenville, MS 38703-3247, 662-335-0183 |
| Mailing address | PO BOX 5368, Greenville, MS 38704-5368 |
| Specialties | Internal Medicine, Cardiovascular Disease (207RC0000X, primary, license 09800 MS) |
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 | $551K | 42% | $42 | $60 (top 5% from $133) | 27th percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $174K | 13% | $120 | $96 (top 5% from $249) | 65th percentile | |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | $169K | 13% | $54 | $52 (top 5% from $244) | 52nd percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $133K | 10% | $68 | $67 (top 5% from $174) | 50th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $118K | 9% | $76 | $81 (top 5% from $170) | 45th percentile | |
| 93925 | Ultrasound of leg arteries or artery grafts | $22K | 2% | $66 | $65 (top 5% from $198) | 51st percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $18K | 1% | $18 | $44 (top 5% from $110) | 15th percentile | |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $17K | 1% | $4.52 | $5.72 (top 5% from $13) | 31st percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 2,101 | 226 | $169K | $194 | $103 | 1.9x | 2.6x (90th percentile 4.7x) |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 1,973 | 208 | $106K | $134 | $69 | 2.0x | 2.6x (90th percentile 4.3x) |
| 37225 | Removal of plaque in arteries of leg | 18 | 15 | $93K | $18K | $7K | 2.7x | 3.8x (90th percentile 8.0x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 635 | 282 | $49K | $210 | $109 | 1.9x | 2.3x (90th percentile 3.8x) |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 430 | 416 | $33K | $875 | $105 | 8.3x | 3.4x (90th percentile 7.7x) |
| 93229 | Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional | 49 | 47 | $25K | $1K | $644 | 1.6x | 2.1x (90th percentile 3.2x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 143 | 112 | $16K | $376 | $150 | 2.5x | 3.0x (90th percentile 5.6x) |
| 93458 | Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist | 74 | 70 | $14K | $2K | $247 | 9.7x | 3.9x (90th percentile 10.2x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
3 providers in Washington County, MS carry an indicator in the public record, with $737K at stake between them. The most common is paid after a public list action, on 2 of them, followed by more hours than a day holds on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | MILESTONE COMMUNITY DEVELOPMENT CENTER Greenville, MS, ranked 31 | $415K |
|
| 4 | SATWINDER SINGH Greenville, MS, ranked 9361 | $297K |
|
| 5 | FIRST CHOICE HOME MEDICAL EQUIPMENT INC. Greenville, MS, ranked 11855 | $25K |
Recent enforcement in MS
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.