DAVID GERHARDT PAULSRUD, MD
NPI 1255655635, individual, Sioux City, IA, Family Medicine, Addiction Medicine
- Hours beyond a day in 2 months, but with up to 627 patients a month, 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jul 2019 | More hours than a day holds, even counting one unit per claim line | 25.9 | 39.1 | 26.1 | 35.1 | 627 | 1 | 90791 90832 90834 90837 90853 | $120K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 24.8 | 29.1 | 19.4 | 26.5 | 522 | 1 | 90791 90832 90834 90853 | $93K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DAVID GERHARDT PAULSRUD, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | March 15, 2010, last updated March 15, 2010 |
| Practice location | 800 5TH ST, Sioux City, IA 51101-1317, 712-234-2349 |
| Mailing address | 325 45TH ST, Sioux City, IA 51104-1075 |
| Specialties | Family Medicine, Addiction Medicine (207QA0401X, primary, license 16104 IA) |
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 | |
|---|---|---|---|---|---|---|---|
| H0035 | Mental health partial hospitalization less than 24 hours | $1.2M | 27% | $2K | $1K (top 5% from $3K) | 79th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $1.1M | 25% | $252 | $60 (top 5% from $332) | 92nd percentile | |
| 90834 | Psychotherapy, 45 minutes | $1.0M | 22% | $152 | $101 (top 5% from $318) | 73rd percentile | |
| H0015 | Alcohol/drug intensive outpatient per diemhistory of abuse | $623K | 14% | $437 | $666 (top 5% from $2K) | 27th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $286K | 6% | $106 | $105 (top 5% from $228) | 51st percentile | |
| H2034 | Alcohol/drug halfway house services per diem | $187K | 4% | $938 | $2K (top 5% from $4K) | 19th percentile | |
| 80305 | Testing for presence of drug, read by direct observation | $47K | 1% | $19 | $9.23 (top 5% from $22) | 93rd percentile | |
| 90832 | Psychotherapy, 30 minutes | $41K | 1% | $54 | $59 (top 5% from $239) | 44th percentile |
In this area
3 providers in Woodbury County, IA carry an indicator in the public record, with $4.7M at stake between them. The most common is paid after a public list action, on 1 of them, followed by named in an enforcement record on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | PATRICK CHAU Sioux City, IA, ranked 4 | $489K |
|
| 3 | AMY HECHT Sioux City, IA, ranked 1765 | $0 |
|
| 4 | RANDALL WOOD Sioux City, IA, ranked 7483 | $4.2M |
|
Recent enforcement in IA
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.