SAMUEL WERZBERGER, M.D.
NPI 1801278395, individual, Monroe, NY, Pediatrics
- Hours beyond a day in 2 months, but with up to 1856 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 2019 | More hours than a day holds, even counting one unit per claim line | 24.3 | 25.2 | 16.8 | 22.6 | 1849 | 1 | 99202 99203 99204 99212 99213 99214 | $114K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 28.4 | 29.8 | 19.9 | 27.8 | 1856 | 1 | 99202 99203 99204 99212 99213 99214 | $117K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 32.7 | 41.7 | 27.8 | 37.4 | 2042 | 1 | 99203 99204 99211 99212 99213 99214 | $155K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 27.0 | 38.4 | 25.6 | 37.8 | 1699 | 1 | 99203 99211 99212 99213 99214 | $136K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 24.1 | 33.2 | 22.1 | 31.0 | 1413 | 1 | 99203 99212 99213 99214 | $107K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 24.6 | 36.5 | 24.3 | 33.1 | 1533 | 1 | 99203 99211 99212 99213 99214 | $127K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 30.9 | 44.1 | 29.4 | 41.5 | 1911 | 1 | 99203 99212 99213 99214 | $157K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 27.0 | 40.3 | 26.9 | 37.9 | 1758 | 1 | 99203 99211 99212 99213 99214 | $143K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 29.8 | 44.9 | 30.0 | 41.9 | 1778 | 1 | 99203 99212 99213 99214 | $144K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 27.1 | 41.2 | 27.5 | 37.0 | 1787 | 1 | 99203 99212 99213 99214 99441 | $147K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 30.1 | 37.6 | 25.1 | 33.8 | 1693 | 1 | 99203 99212 99213 99214 99441 | $135K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 28.0 | 40.0 | 26.7 | 36.4 | 1735 | 1 | 99203 99212 99213 99214 99441 | $139K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 32.7 | 42.8 | 28.5 | 42.1 | 1913 | 1 | 99203 99212 99213 99214 99441 | $153K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 30.0 | 39.2 | 26.1 | 35.2 | 1764 | 1 | 99203 99212 99213 99214 99441 | $139K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 25.6 | 35.9 | 24.0 | 34.2 | 1599 | 1 | 99203 99212 99213 99214 99441 | $124K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 25.6 | 34.9 | 23.2 | 32.7 | 1610 | 1 | 99203 99212 99213 99214 99441 | $125K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 38.9 | 56.3 | 37.5 | 51.2 | 2320 | 1 | 99203 99212 99213 99214 99441 | $194K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 34.4 | 51.5 | 34.3 | 50.7 | 2205 | 1 | 99203 99204 99212 99213 99214 99441 | $183K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 43.2 | 57.4 | 38.3 | 51.6 | 2516 | 1 | 99203 99204 99212 99213 99214 | $204K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 37.8 | 45.0 | 30.0 | 41.5 | 1953 | 1 | 99203 99204 99212 99213 99214 | $150K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 35.8 | 42.4 | 28.3 | 41.7 | 1962 | 1 | 99203 99204 99212 99213 99214 | $151K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 26.3 | 36.7 | 24.5 | 33.3 | 1647 | 1 | 99203 99212 99213 99214 | $127K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 26.8 | 41.8 | 27.9 | 37.5 | 1835 | 1 | 99203 99212 99213 99214 | $151K |
| Jul 2024 | More hours than a day holds at a conservative unit price | 22.8 | 36.4 | 24.2 | 32.7 | 1600 | 1 | 99212 99213 99214 99441 | $131K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 28.3 | 38.3 | 25.5 | 36.4 | 1622 | 1 | 99203 99212 99213 99214 99441 | $133K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SAMUEL WERZBERGER, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | June 22, 2015, last updated June 22, 2015 |
| Practice location | 22 VAN BUREN DR, SUITE 102, Monroe, NY 10950-6018, 845-783-2222 |
| Specialties | Pediatrics (208000000X, primary, license 280539 NY) |
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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $5.3M | 44% | $75 | $44 (top 5% from $110) | 86th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.2M | 10% | $91 | $60 (top 5% from $133) | 79th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $767K | 6% | $74 | $67 (top 5% from $121) | 60th percentile | |
| 99392 | Medicaid service code | $635K | 5% | $80 | $78 (top 5% from $124) | 54th percentile | |
| 99391 | Medicaid service code | $505K | 4% | $73 | $76 (top 5% from $126) | 46th percentile | |
| 90460 | Administration of first vaccine or toxoid component with counseling (18 years or younger) | $364K | 3% | $24 | $26 (top 5% from $54) | 46th percentile | |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | $360K | 3% | $11 | $12 (top 5% from $18) | 43rd percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $267K | 2% | $104 | $95 (top 5% from $171) | 59th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 18 | 17 | $1K | $350 | $117 | 3.0x | 2.4x (90th percentile 3.9x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 30 | 25 | $1K | $250 | $96 | 2.6x | 2.2x (90th percentile 3.8x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 12 | 12 | $831 | $316 | $134 | 2.4x | 2.3x (90th percentile 3.8x) |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 28 | 14 | $454 | $78 | $16 | 4.8x | 2.5x (90th percentile 3.9x) |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 12 | 12 | $415 | $160 | $35 | 4.6x | 2.8x (90th percentile 4.4x) |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 12 | 11 | $194 | $75 | $16 | 4.6x | 2.6x (90th percentile 4.1x) |
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
14 providers in Orange County, NY carry an indicator in the public record, with $12.6M at stake between them. The most common is more hours than a day holds, on 10 of them, followed by paid after a public list action on 4. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | PAUL FELDMAN Newburgh, NY, ranked 23 | $25K |
|
| 4 | TANISHA CASTELLANOS Goshen, NY, ranked 7303 | $2.5M |
|
| 4 | LAZAR KHAIMOV Monroe, NY, ranked 7526 | $3.4M |
|
| 4 | TZVI FARKAS Monroe, NY, ranked 8048 | $157K |
|
| 4 | YITZCHOK SCHLAFRIG Monroe, NY, ranked 9014 | $921K |
|
| 4 | SAMUEL WEISER Monroe, NY, ranked 9193 | $536K |
|
| 4 | OSA GUOBADIA Middletown, NY, ranked 9692 | $27K |
|
| 5 | ERROL YOUNG Warwick, NY, ranked 10206 | $641K |
|
Recent enforcement in NY
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.