Providers

MICHAEL LAWLOR, MD

NPI 1861597817, individual, Hartford, CT, Internal Medicine, Infectious Disease

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 4 months, but with up to 267 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 51 of 100, rank 8901, $1.3M at stake

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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Mar 2023More hours than a day holds, even counting one unit per claim line66.512.98.611.6172199213 99222 99231 99232$16K
Apr 2023More hours than a day holds, even counting one unit per claim line62.714.99.914.9220199213 99222 99231 99232$18K
May 2023More hours than a day holds, even counting one unit per claim line43.314.39.512.8206199222 99231 99232$18K
Jun 2023More hours than a day holds, even counting one unit per claim line26.813.69.112.4181199213 99222 99231 99232$17K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameMICHAEL LAWLOR, MD
TypeIndividual
StatusActive
NPI issuedSeptember 14, 2006, last updated February 23, 2010
Practice location100 RETREAT AVE, SUITE 903, Hartford, CT 06106-2528, 860-244-0148
Mailing addressPO BOX 587, Rocky Hill, CT 06067-0587
Specialties
Internal Medicine, Infectious Disease (207RI0200X, primary, license 028463 CT)

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.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$1.1M76%$171$67 (top 5% from $174)95th percentile
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes$285K20%$42$63 (top 5% from $137)24th percentile
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes$37K3%$12$37 (top 5% from $103)5th percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$26K2%$42$44 (top 5% from $110)48th percentile
99254Medicaid service code$9650%$80$90 (top 5% from $178)too few months to rank
Medicare Part B 2024, largest codes
codewhat it isservicesbeneficiariespaidsubmitted per serviceallowed per servicecharge to allowedusual for this code
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2,555501$162K$135$801.7x2.6x (90th percentile 4.3x)
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes2,775407$111K$85$501.7x2.4x (90th percentile 4.0x)
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes801633$83K$246$1331.8x2.7x (90th percentile 4.4x)
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more8370$6K$136$951.4x2.2x (90th percentile 3.8x)

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

33 providers in Hartford, CT carry an indicator in the public record, with $12.7M at stake between them. The most common is named in an enforcement record, on 12 of them, followed by more hours than a day holds on 9. 12 are tier 1: documented action, then payment.

tierproviderat stakewhy
1SHAWN TYSON
Hartford, CT, ranked 62
$0
  • Adjudicated (sentenced, pleaded guilty) per a Department of Justice release dated June 21, 2024.
  • No Medicaid payments in the last 12 observed months.
  • and 2 more
1MINDS CORNERSTONE LLC
Wethersfield, CT, ranked 74
$721K
  • Adjudicated (complaint, pleaded guilty) per a Department of Justice release and an HHS-OIG enforcement record dated January 16, 2025.
  • Medicaid paid $721,009 in the last 12 observed months.
1HELEN ZERVAS
Bristol, CT, ranked 112
$192K
  • Adjudicated (pleaded guilty, indicted) per a Department of Justice release dated February 11, 2025.
  • Medicaid paid $192,083 in the last 12 observed months.
1SORAYA SAWICKI
Avon, CT, ranked 133
$131K
  • Adjudicated (sentenced) per a state attorney general release dated June 3, 2025.
  • Medicaid paid $130,870 in the last 12 observed months.
1MICHAEL PINES
Glastonbury, CT, ranked 444
$0
  • Adjudicated (sentenced, pleaded guilty) per a Department of Justice release dated January 31, 2024.
  • No Medicaid payments in the last 12 observed months.
  • and 1 more
1THE GEMINI PROJECT, LLC
Newington, CT, ranked 446
$0
  • Adjudicated (pleaded guilty, complaint) per a Department of Justice release dated January 16, 2025.
  • No Medicaid payments in the last 12 observed months.
  • and 1 more
1COLLABORATIVE COUNSELING CENTER, LLC
Hartford, CT, ranked 550
$0
  • Adjudicated (sentenced) per a state attorney general release dated August 28, 2024.
  • No Medicaid payments in the last 12 observed months.
1DONALD SALZBERG
West Hartford, CT, ranked 575
$0
  • Adjudicated (sentenced) per a Department of Justice release dated May 9, 2024.
  • No Medicaid payments in the last 12 observed months.
All 33 in CT

Recent enforcement in CT

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementJun 23, 2026
Connecticut Lab and its Owner Pay Over $145K to Settle Allegations of Medicaid Enrollment Fraud
Coastal Diagnostics and its owner made material misrepresentations in a Connecticut Medicaid Provider Enrollment Application by denying any relationship to another enrolled provider, Genco Lab, and then submitted claims for laboratory services.
DOJPleaded guiltyJun 23, 2026
Middletown Man Pleads Guilty to Operating Unlawful Money Transmitting Business
Habib registered a company and opened a bank account through which fraudulent claims were submitted to Medicare Advantage plans for durable medical equipment, including orthotics and braces, that beneficiaries did not request, consent to, or receive, and he wired proceeds to Pakistan without a money transmitting license.
DOJComplaint filedMay 22, 2026
APRN Charged with Defrauding Connecticut’s Medicaid Program
An APRN was charged with submitting fraudulent Medicaid claims for medication management services that were not provided, including for patients who had stopped seeing her or who were hospitalized, incarcerated, or deceased.
DOJSentencedApr 30, 2026
Cheshire Nurse Who Illegally Distributed Controlled Substances is Sentenced
An Advanced Practice Registered Nurse enrolled as a Medicare and Medicaid provider unlawfully distributed amphetamines and benzodiazepines to individuals without legitimate medical need, charging $200 cash for office visits, and Medicaid paid $287.58 for prescriptions written for an undercover agent.
DOJSentencedFeb 10, 2026
Bloomfield Man Sentenced to Federal Prison for Health Care Fraud
Tyson and Epps submitted fraudulent Medicaid claims for psychotherapy counseling sessions that were not provided, billed under Tyson's provider number for services purportedly provided by the suspended Epps, and Tyson provided fraudulent patient records during a Medicaid audit.

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.

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