RANDALL GLEN WOOD, MD
NPI 1730407545, individual, Sioux City, IA, Emergency Medicine
- Hours beyond a day in 5 months, but with up to 680 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 H0018 ($13371 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 |
|---|---|---|---|---|---|---|---|---|---|
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 28.1 | 25.6 | 17.1 | 23.0 | 583 | 1 | 90791 90832 90834 90853 99211 | $98K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 25.5 | 24.6 | 16.4 | 23.0 | 602 | 1 | 90791 90832 90834 90853 99211 | $101K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 26.5 | 26.2 | 17.5 | 23.5 | 665 | 1 | 90791 90832 90834 90853 99211 | $119K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 27.3 | 26.8 | 17.9 | 24.1 | 680 | 1 | 90791 90832 90834 90853 99211 | $122K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 25.6 | 24.6 | 16.4 | 22.3 | 638 | 1 | 90791 90832 90834 90853 99211 | $108K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RANDALL GLEN WOOD, MD |
| Type | Individual |
| Status | Active |
| NPI issued | May 4, 2010, last updated March 19, 2014 |
| Practice location | 2720 STONE PARK BLVD., Sioux City, IA 51104, 712-279-3141 |
| Specialties | Emergency Medicine (207P00000X, primary, license MD-40959 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 | |
|---|---|---|---|---|---|---|---|
| H0018 | Behavioral health short-term residential per diem | $9.7M | 47% | $13K | $3K (top 5% from $7K) | 100th percentile | |
| H2034 | Alcohol/drug halfway house services per diem | $3.4M | 16% | $4K | $2K (top 5% from $4K) | 94th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $2.1M | 10% | $296 | $60 (top 5% from $332) | 94th percentile | |
| 90834 | Psychotherapy, 45 minutes | $1.4M | 7% | $156 | $101 (top 5% from $318) | 74th percentile | |
| H0015 | Alcohol/drug intensive outpatient per diemhistory of abuse | $1.4M | 7% | $836 | $666 (top 5% from $2K) | 66th percentile | |
| 99284 | Emergency department visit with moderate level of medical decision making | $744K | 4% | $146 | $86 (top 5% from $224) | 84th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $698K | 3% | $109 | $105 (top 5% from $228) | 55th percentile | |
| 99283 | Emergency department visit with low level of medical decision making | $547K | 3% | $127 | $60 (top 5% from $193) | 83rd 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 | 147 | 144 | $18K | $403 | $160 | 2.5x | 6.9x (90th percentile 11.7x) |
| 99284 | Emergency department visit with moderate level of medical decision making | 70 | 69 | $5K | $278 | $111 | 2.5x | 6.7x (90th percentile 11.3x) |
| 99291 | Critical care, first 30-74 minutes | 33 | 33 | $5K | $641 | $195 | 3.3x | 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
3 providers in Woodbury County, IA carry an indicator in the public record, with $2.9M 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 | DAVID PAULSRUD Sioux City, IA, ranked 8649 | $2.4M |
|
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.