MICHAEL LAWLOR, MD
NPI 1861597817, individual, Hartford, CT, Internal Medicine, Infectious Disease
- 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.
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 2023 | More hours than a day holds, even counting one unit per claim line | 66.5 | 12.9 | 8.6 | 11.6 | 172 | 1 | 99213 99222 99231 99232 | $16K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 62.7 | 14.9 | 9.9 | 14.9 | 220 | 1 | 99213 99222 99231 99232 | $18K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 43.3 | 14.3 | 9.5 | 12.8 | 206 | 1 | 99222 99231 99232 | $18K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 26.8 | 13.6 | 9.1 | 12.4 | 181 | 1 | 99213 99222 99231 99232 | $17K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MICHAEL LAWLOR, MD |
| Type | Individual |
| Status | Active |
| NPI issued | September 14, 2006, last updated February 23, 2010 |
| Practice location | 100 RETREAT AVE, SUITE 903, Hartford, CT 06106-2528, 860-244-0148 |
| Mailing address | PO 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.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $1.1M | 76% | $171 | $67 (top 5% from $174) | 95th percentile | |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | $285K | 20% | $42 | $63 (top 5% from $137) | 24th percentile | |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | $37K | 3% | $12 | $37 (top 5% from $103) | 5th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $26K | 2% | $42 | $44 (top 5% from $110) | 48th percentile | |
| 99254 | Medicaid service code | $965 | 0% | $80 | $90 (top 5% from $178) | too few months to rank |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 2,555 | 501 | $162K | $135 | $80 | 1.7x | 2.6x (90th percentile 4.3x) |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 2,775 | 407 | $111K | $85 | $50 | 1.7x | 2.4x (90th percentile 4.0x) |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 801 | 633 | $83K | $246 | $133 | 1.8x | 2.7x (90th percentile 4.4x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 83 | 70 | $6K | $136 | $95 | 1.4x | 2.2x (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.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | SHAWN TYSON Hartford, CT, ranked 62 | $0 |
|
| 1 | MINDS CORNERSTONE LLC Wethersfield, CT, ranked 74 | $721K |
|
| 1 | HELEN ZERVAS Bristol, CT, ranked 112 | $192K |
|
| 1 | SORAYA SAWICKI Avon, CT, ranked 133 | $131K |
|
| 1 | MICHAEL PINES Glastonbury, CT, ranked 444 | $0 |
|
| 1 | THE GEMINI PROJECT, LLC Newington, CT, ranked 446 | $0 |
|
| 1 | COLLABORATIVE COUNSELING CENTER, LLC Hartford, CT, ranked 550 | $0 |
|
| 1 | DONALD SALZBERG West Hartford, CT, ranked 575 | $0 |
|
Recent enforcement in CT
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.