RON ELFENBEIN, MD
NPI 1710934294, individual, Baltimore, MD, Emergency Medicine
- Hours beyond a day in 1 month, but with up to 1633 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 |
|---|---|---|---|---|---|---|---|---|---|
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 31.3 | 28.7 | 19.2 | 25.8 | 1633 | 1 | 99204 99205 99212 99213 99214 99417 99441 | $164K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RON ELFENBEIN, MD |
| Type | Individual |
| Status | Active |
| NPI issued | May 28, 2006, last updated March 4, 2010 |
| Practice location | 3001 S HANOVER ST, Baltimore, MD 21225-1233, 410-350-3509 |
| Mailing address | 7023 CHESAPEAKE HARBOUR DR E, Annapolis, MD 21403-7603 |
| Specialties | Emergency Medicine (207P00000X, primary, license D60177 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 | |
|---|---|---|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $457K | 29% | $107 | $95 (top 5% from $171) | 62nd percentile | |
| S9083 | Medicaid service code | $251K | 16% | $144 | $113 (top 5% from $163) | 80th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $185K | 12% | $74 | $44 (top 5% from $110) | 85th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $174K | 11% | $107 | $60 (top 5% from $133) | 89th percentile | |
| 87428 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | $132K | 8% | $62 | $44 (top 5% from $75) | 75th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $107K | 7% | $36 | $32 (top 5% from $49) | 65th percentile | |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | $72K | 5% | $43 | $44 (top 5% from $70) | 45th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $54K | 3% | $66 | $28 (top 5% from $147) | 86th percentile |
In this area
2 providers in Anne Arundel County, MD carry an indicator in the public record, with $430K at stake between them. The most common is more hours than a day holds, on 1 of them, followed by paid after a public list action on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | THEMBI DEPASS Annapolis, MD, ranked 9261 | $423K |
|
| 5 | IRENE IRBY Annapolis, MD, ranked 11948 | $7K |
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.