NORMAN M BALOG, D.O.
NPI 1285624577, individual, Silver Spring, MD, Family Medicine
- Hours beyond a day in 13 months, but with up to 2313 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 31.7 | 29.0 | 19.4 | 28.6 | 1683 | 1 | 99203 99204 99205 99213 99214 99215 | $184K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 24.2 | 23.6 | 15.8 | 22.5 | 1259 | 1 | 99203 99204 99205 99213 99214 99215 | $146K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 24.5 | 24.5 | 16.3 | 23.0 | 1330 | 1 | 99203 99204 99205 99213 99214 99215 | $156K |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 24.2 | 24.6 | 16.4 | 22.4 | 1306 | 1 | 99203 99204 99205 99213 99214 99215 | $152K |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 35.3 | 37.5 | 25.0 | 36.9 | 1922 | 1 | 99203 99204 99205 99213 99214 99215 | $241K |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 36.6 | 35.7 | 23.8 | 32.0 | 1844 | 1 | 99203 99204 99205 99213 99214 99215 | $228K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 41.5 | 42.3 | 28.2 | 38.5 | 2159 | 1 | 99203 99204 99205 99213 99214 99215 | $262K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 44.2 | 45.9 | 30.6 | 45.2 | 2103 | 1 | 99203 99204 99205 99213 99214 99215 | $294K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 42.8 | 47.4 | 31.6 | 43.1 | 2313 | 1 | 99203 99204 99205 99213 99214 99215 | $295K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 31.2 | 32.3 | 21.5 | 30.4 | 1712 | 1 | 99203 99204 99205 99213 99214 99215 | $211K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 30.8 | 32.5 | 21.7 | 30.5 | 1772 | 1 | 99203 99204 99205 99213 99214 99215 | $219K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 29.3 | 28.5 | 19.0 | 26.6 | 1490 | 1 | 99203 99204 99213 99214 99215 | $176K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 31.6 | 32.4 | 21.6 | 29.1 | 1756 | 1 | 99203 99204 99213 99214 99215 | $223K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | NORMAN M BALOG, D.O. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | October 27, 2005, last updated October 19, 2010 |
| Practice location | 15504 WILLISTON RD, DOC AT YOUR DOOR, LLC, Silver Spring, MD 20905-4243, 301-879-0179 |
| Specialties | Family Medicine (207Q00000X, primary, license H0048219 MD) |
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 | $3.7M | 47% | $118 | $60 (top 5% from $133) | 92nd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.2M | 15% | $107 | $44 (top 5% from $110) | 95th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $899K | 12% | $131 | $95 (top 5% from $171) | 79th percentile | |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | $773K | 10% | $40 | $33 (top 5% from $45) | 81st percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $397K | 5% | $114 | $67 (top 5% from $121) | 93rd 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 | $188K | 2% | $137 | $88 (top 5% from $210) | 80th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $154K | 2% | $34 | $32 (top 5% from $49) | 58th percentile | |
| 87400 | Detection test by immunoassay technique for influenza virus | $110K | 1% | $21 | $15 (top 5% from $56) | 71st percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 19 | 18 | $658 | $175 | $52 | 3.4x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 13 | 13 | $430 | $135 | $52 | 2.6x | 2.2x (90th percentile 3.8x) |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 15 | 14 | $89 | $75 | $6 | 12.6x | 2.1x (90th percentile 4.3x) |
| 87400 | Detection test by immunoassay technique for influenza virus | 24 | 12 | $60 | $50 | $3 | 19.9x | 3.0x (90th percentile 6.1x) |
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
12 providers in Montgomery County, MD carry an indicator in the public record, with $10.0M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by named in an enforcement record on 3. 3 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ELIA TORRES Takoma Park, MD, ranked 25 | $14K |
|
| 1 | RICHARD O AKOTO MD PA Takoma Park, MD, ranked 510 | $0 |
|
| 1 | RICHARD AKOTO Takoma Park, MD, ranked 516 | $0 |
|
| 3 | ADVENTIST HOME HEALTH SERVICES INC Silver Spring, MD, ranked 1439 | $42K |
|
| 3 | SILVER SPRING HEALTH, LLC Silver Spring, MD, ranked 2862 | $0 |
|
| 3 | JEWISH SOCIAL SERVICE AGENCY Rockville, MD, ranked 4017 | $0 |
|
| 4 | MANBIR TAKHAR Germantown, MD, ranked 8860 | $1.4M |
|
| 4 | MARC WEBER Olney, MD, ranked 9016 | $918K |
|
Recent enforcement in MD
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.