WENDEE KAY BURNETT, APRN, BC
NPI 1750425344, individual, Rio Rancho, NM, Nurse Practitioner, Family
- Hours beyond a day in 5 months, but with up to 372 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 99233 ($360 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 |
|---|---|---|---|---|---|---|---|---|---|
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 24.6 | 29.2 | 19.5 | 26.6 | 343 | 1 | 90833 99223 99233 99239 | $82K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 25.0 | 26.2 | 17.5 | 23.5 | 326 | 1 | 90833 99223 99233 99239 | $76K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 24.6 | 28.1 | 18.7 | 28.1 | 328 | 1 | 90833 99223 99233 99239 | $79K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 27.0 | 32.4 | 21.6 | 29.1 | 372 | 1 | 90833 99223 99233 99239 | $93K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 24.1 | 30.4 | 20.2 | 28.5 | 354 | 1 | 90833 99223 99233 99239 | $88K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | WENDEE KAY BURNETT, APRN, BC |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | February 16, 2007, last updated April 8, 2019 |
| Practice location | 4101 BARBARA LOOP SE STE B, Rio Rancho, NM 87124-1011, 505-553-4014 |
| Specialties | Nurse Practitioner, Family (363LF0000X, primary, license R11553 NM) |
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 | |
|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $708K | 42% | $360 | $96 (top 5% from $249) | 99th percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $288K | 17% | $152 | $49 (top 5% from $109) | 98th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $240K | 14% | $173 | $81 (top 5% from $170) | 95th percentile | |
| 95165 | Professional service for preparation and provision of 1 or more antigens | $189K | 11% | $1K | $187 (top 5% from $1K) | 95th percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $139K | 8% | $101 | $49 (top 5% from $101) | 95th percentile | |
| 99284 | Emergency department visit with moderate level of medical decision making | $40K | 2% | $89 | $86 (top 5% from $224) | 54th percentile | |
| 95004 | Test for allergy using allergenic extract | $28K | 2% | $237 | $136 (top 5% from $315) | 85th percentile | |
| 99283 | Emergency department visit with low level of medical decision making | $18K | 1% | $56 | $60 (top 5% from $193) | 46th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 454 | 65 | $34K | $129 | $94 | 1.4x | 2.6x (90th percentile 4.7x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 452 | 64 | $19K | $92 | $52 | 1.8x | 2.1x (90th percentile 3.5x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 55 | 46 | $6K | $230 | $138 | 1.7x | 3.0x (90th percentile 5.6x) |
| 99239 | Hospital discharge day management, more than 30 minutes | 58 | 48 | $4K | $138 | $91 | 1.5x | 2.8x (90th percentile 5.6x) |
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 Sandoval County, NM carry an indicator in the public record, with $4.7M at stake between them. The most common is more hours than a day holds, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | ROBBEN GINGERY Rio Rancho, NM, ranked 7476 | $4.5M |
|
| 5 | JANE-FRANCES SHITI Rio Rancho, NM, ranked 10377 | $224K |
|
Recent enforcement in NM
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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.