BRIAN E ZGANJAR, M.D.
NPI 1174559470, individual, Denham Springs, LA, Pediatrics
- Hours beyond a day in 2 months, but with up to 1538 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- 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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 26.4 | 35.3 | 23.5 | 33.0 | 1465 | 2 | 99204 99212 99213 99214 | $101K |
| Nov 2019 | More hours than a day holds, even counting one unit per claim line | 24.1 | 30.4 | 20.3 | 29.0 | 1538 | 3 | 99212 99213 99214 | $95K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | BRIAN E ZGANJAR, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | June 25, 2006, last updated June 27, 2020 |
| Practice location | 1213 NORTH RANGE AVE, Denham Springs, LA 70726, 225-665-6677 |
| Specialties | Pediatrics (208000000X, primary, license 022406 LA) |
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 | 42% | $79 | $60 (top 5% from $133) | 69th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $558K | 19% | $52 | $44 (top 5% from $110) | 62nd percentile | |
| 99392 | Medicaid service code | $182K | 6% | $68 | $78 (top 5% from $124) | 36th percentile | |
| 99391 | Medicaid service code | $141K | 5% | $62 | $76 (top 5% from $126) | 30th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $128K | 4% | $28 | $28 (top 5% from $147) | 51st percentile | |
| 99393 | Medicaid service code | $123K | 4% | $66 | $78 (top 5% from $121) | 36th percentile | |
| 90471 | Administration of vaccine | $95K | 3% | $14 | $10 (top 5% from $23) | 68th percentile | |
| 99394 | Medicaid service code | $91K | 3% | $75 | $83 (top 5% from $128) | 42nd percentile |
In this area
2 providers in Livingston Parish County, LA carry an indicator in the public record, with $426K 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 | LTD GROUP LLC Denham Springs, LA, ranked 4783 | $0 |
|
| 5 | AMBER BAYHI Holden, LA, ranked 11262 | $426K |
Recent enforcement in LA
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.