KRISTA M BRUCKER, md
NPI 1497076376, individual, Greenfield, IN, Preventive Medicine, Addiction Medicine
- Hours beyond a day in 3 months, but with up to 1499 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 | 32.9 | 35.1 | 23.4 | 34.6 | 1206 | 2 | 90834 90853 99213 99214 | $76K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 46.7 | 62.8 | 41.9 | 58.7 | 1373 | 2 | 90791 90853 99213 99214 | $120K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 29.6 | 35.5 | 23.7 | 31.9 | 1499 | 2 | 90853 99213 99214 | $81K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | KRISTA M BRUCKER, md |
| Type | Individual |
| Status | Active |
| NPI issued | June 15, 2010, last updated June 21, 2022 |
| Practice location | 147 W GREEN MEADOWS DR STE 2, Greenfield, IN 46140-4000, 317-318-0367 |
| Mailing address | 615 N MICHIGAN ST, South Bend, IN 46601-1033 |
| Specialties | Emergency Medicine (207P00000X, license 01071924A IN) Preventive Medicine, Addiction Medicine (2083A0300X, license MD-49601 IA) Psychiatry & Neurology, Addiction Medicine (2084A0401X, license 01071924A IN) Preventive Medicine, Addiction Medicine (2083A0300X, primary, license 01071924A IN) |
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 | |
|---|---|---|---|---|---|---|---|
| H0047 | Medicaid service code | $778K | 30% | $418 | $300 (top 5% from $6K) | 56th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $756K | 29% | $51 | $60 (top 5% from $332) | 42nd percentile | |
| 99283 | Emergency department visit with low level of medical decision making | $251K | 10% | $122 | $60 (top 5% from $193) | 82nd percentile | |
| 99284 | Emergency department visit with moderate level of medical decision making | $214K | 8% | $94 | $86 (top 5% from $224) | 59th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $175K | 7% | $75 | $44 (top 5% from $110) | 85th percentile | |
| 80305 | Testing for presence of drug, read by direct observation | $143K | 6% | $26 | $9.23 (top 5% from $22) | 97th percentile | |
| 99285 | Emergency department visit with high level of medical decision making | $113K | 4% | $91 | $100 (top 5% from $264) | 38th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $42K | 2% | $90 | $60 (top 5% from $133) | 79th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 63 | 63 | $8K | $1K | $161 | 7.2x | 6.9x (90th percentile 11.7x) |
| 99284 | Emergency department visit with moderate level of medical decision making | 41 | 41 | $3K | $798 | $111 | 7.2x | 6.7x (90th percentile 11.3x) |
| 99291 | Critical care, first 30-74 minutes | 15 | 15 | $2K | $2K | $196 | 9.2x | 4.7x (90th percentile 10.0x) |
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
2 providers in Hancock County, IN carry an indicator in the public record, with $10.4M at stake between them. The most common is paid after a public list action, on 1 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 | GREEN HOUSE AND ASSOCIATES INC Mccordsville, IN, ranked 258 | $16K |
|
| 4 | HEATHER DOWNHOUR Greenfield, IN, ranked 8292 | $10.4M |
|
Recent enforcement in IN
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.