HILLEL PELTZ, DO
NPI 1881622074, individual, Lakewood, NJ, Emergency Medicine
- Hours beyond a day in 10 months, but with up to 2007 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 |
|---|---|---|---|---|---|---|---|---|---|
| Dec 2019 | More hours than a day holds at a conservative unit price | 21.4 | 46.0 | 30.7 | 43.2 | 1422 | 1 | 99203 99204 99213 99214 | $153K |
| Oct 2020 | More hours than a day holds at a conservative unit price | 22.4 | 43.5 | 29.0 | 40.9 | 1792 | 1 | 99202 99203 99204 99213 99214 | $166K |
| Nov 2020 | More hours than a day holds, even counting one unit per claim line | 24.4 | 48.1 | 32.1 | 45.8 | 1764 | 1 | 99202 99203 99204 99211 99213 99214 | $172K |
| Jan 2021 | More hours than a day holds at a conservative unit price | 21.8 | 45.7 | 30.4 | 44.9 | 1625 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $167K |
| Feb 2021 | More hours than a day holds at a conservative unit price | 19.7 | 42.5 | 28.3 | 39.7 | 1342 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $141K |
| Mar 2021 | More hours than a day holds at a conservative unit price | 20.0 | 41.9 | 27.9 | 37.6 | 1604 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $157K |
| Jul 2021 | More hours than a day holds at a conservative unit price | 17.9 | 37.2 | 24.8 | 35.0 | 1568 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $145K |
| Aug 2021 | More hours than a day holds at a conservative unit price | 21.8 | 41.4 | 27.6 | 38.9 | 2007 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $165K |
| Dec 2021 | More hours than a day holds at a conservative unit price | 19.1 | 40.7 | 27.2 | 36.6 | 1535 | 1 | 99202 99203 99204 99212 99213 99214 | $151K |
| Dec 2022 | More hours than a day holds at a conservative unit price | 16.7 | 36.5 | 24.3 | 34.3 | 1190 | 1 | 99203 99204 99212 99213 99214 | $129K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | HILLEL PELTZ, DO |
| Type | Individual |
| Status | Active |
| NPI issued | June 28, 2006, last updated January 18, 2022 |
| Practice location | 940 SOMERSET AVE, Lakewood, NJ 08701-2130, 332-214-3323 |
| Specialties | Internal Medicine (207R00000X, license 25MB07628300 NJ) Emergency Medicine (207P00000X, primary, license 25MB07628300 NJ) |
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 | $2.3M | 30% | $86 | $44 (top 5% from $110) | 91st percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.9M | 25% | $120 | $60 (top 5% from $133) | 93rd percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $812K | 11% | $100 | $67 (top 5% from $121) | 87th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $666K | 9% | $158 | $95 (top 5% from $171) | 92nd percentile | |
| S9083 | Medicaid service code | $399K | 5% | $125 | $113 (top 5% from $163) | 64th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $385K | 5% | $69 | $45 (top 5% from $138) | 81st percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $257K | 3% | $57 | $28 (top 5% from $147) | 84th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $203K | 3% | $46 | $32 (top 5% from $49) | 91st percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 71046 | X-ray of chest, 2 views | 17 | 15 | $498 | $100 | $39 | 2.6x | 3.6x (90th percentile 8.1x) |
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
10 providers in Ocean County, NJ carry an indicator in the public record, with $15.1M at stake between them. The most common is more hours than a day holds, on 6 of them, followed by part of a provider network on 3.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | AFFINITY CARE OF NJ LLC Brick, NJ, ranked 917 | $5.2M |
|
| 3 | RIVERFRONT HEALTHCARE ASSOCIATES INC Bayville, NJ, ranked 1728 | $81 |
|
| 3 | SHORE HEALTH CARE CENTER, INC. Lakewood, NJ, ranked 1738 | $16 |
|
| 3 | NIKKI STEIDLE Toms River, NJ, ranked 7197 | $0 |
|
| 4 | CLARA SUROWITZ Lakewood, NJ, ranked 7986 | $332K |
|
| 4 | ROBERT SHANIK Toms River, NJ, ranked 8109 | $30K |
|
| 4 | ELI EILENBERG Lakewood, NJ, ranked 8349 | $6.7M |
|
| 4 | NORMAN INDICH Lakewood, NJ, ranked 8801 | $1.7M |
|
Recent enforcement in NJ
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.