RANDALL A COLUCCI, DO
NPI 1184618027, individual, Athens, OH, Family Medicine
- Hours beyond a day in 1 month, but with up to 555 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 99214 ($138 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 |
|---|---|---|---|---|---|---|---|---|---|
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 27.2 | 32.7 | 21.8 | 29.4 | 555 | 1 | 90832 90837 90838 99214 99215 | $97K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RANDALL A COLUCCI, DO |
| Type | Individual |
| Status | Active |
| NPI issued | September 7, 2005, last updated September 23, 2010 |
| Practice location | 75 HOSPITAL DR, SUITE 200, CASTROP CENTER, Athens, OH 45701-2857, 740-566-4880 |
| Specialties | Family Medicine (207Q00000X, primary, license 34-007244 OH) |
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 | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $1.0M | 30% | $184 | $191 (top 5% from $442) | 47th percentile | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $696K | 21% | $182 | $88 (top 5% from $210) | 92nd percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $585K | 17% | $138 | $60 (top 5% from $133) | 96th percentile | |
| 90838 | Psychotherapy with evaluation and management visit, 1 hour | $181K | 5% | $164 | $87 (top 5% from $222) | 87th percentile | |
| H0048 | Medicaid service code | $166K | 5% | $29 | $23 (top 5% from $57) | 68th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $124K | 4% | $73 | $44 (top 5% from $110) | 84th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $90K | 3% | $56 | $45 (top 5% from $110) | 66th percentile | |
| 90863 | Medicaid service code | $59K | 2% | $62 | $39 (top 5% from $118) | 77th percentile |
In this area
3 providers in Athens County, OH carry an indicator in the public record, with $2.2M at stake between them. The most common is more hours than a day holds, on 2 of them, followed by part of a provider network on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | ARCADIA VALLEY SKILLED NURSING & REHABILITATION, INC. Coolville, OH, ranked 3138 | $0 |
|
| 4 | KC MONTOYA Athens, OH, ranked 9049 | $830K |
|
| 5 | RONALD GORDINEER Athens, OH, ranked 10920 | $1.4M |
Recent enforcement in OH
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.