Active NPI 1013988286 Individual Practitioner Male Practitioner

Dr. Prabhat Kumar Sinha , MD

Internal Medicine • Toms River, NJ

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Prabhat Sinha, MD is a certified Internal Medicine practicing in Toms River, NJ. With approximately 34 years of clinical experience since completing medical education in 1992, Dr. Sinha delivers high-quality medical care to the local community at 20 HOSPITAL DR.

Dr. Sinha maintains professional affiliations with Ocean Family And Geriatric Associates Llc, Botox And Family Associates Llc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least, subsequent nursing facility care with high level of medical decision making, per day, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

20 Hospital Dr
Ste 3

Toms River, NJ 087556434

Telephone 7323419900

Fax 7323419968

Associated Practice Facility / Clinic

🏢 Mahmood-Schor Urology, P.a. Facility NPI 1215984836

Medicare Profile & Education

Medical School

Other

Graduation Year

1992

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Toms River, NJ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

34 Yrs +6.6 yrs vs City Avg

City Avg: 27.4 Yrs

State Avg: 30.1 Yrs

Regional Practice Density

111 Specialists

Practicing in Toms River, NJ (4957 Statewide)

Telehealth Adoption Rate

24.3% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

36.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sinha (34 Years) 34 Yrs

Toms River Specialty Average (27.4 Years) 27.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,989	479	$250.00	$134.08
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	1,194	328	$303.10	$122.10
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	589	186	$302.84	$81.08
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	450	129	$204.40	$159.77
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	386	309	$350.00	$178.27
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	382	97	$200.00	$112.06
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	379	124	$200.00	$111.98
99238 Hospital discharge day management, 30 minutes or less	339	263	$109.20	$83.88
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	311	95	$204.40	$159.74
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	302	134	$63.70	$62.68
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	257	66	$126.00	$80.04
99213 Established patient office or other outpatient visit, typically 15 minutes	247	153	$150.00	$94.27
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	197	197	$247.47	$135.30
99497 Advance care planning, first 30 minutes	134	132	$122.50	$85.85
99306 Initial nursing facility visit, typically 45 minutes per day	122	107	$249.90	$188.41
G0444 Annual depression screening, 5 to 15 minutes	111	111	$30.92	$20.13
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	106	41	$149.56	$77.12
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	87	42	$192.50	$132.67
99306 Initial nursing facility visit, typically 45 minutes per day	68	64	$249.90	$187.04
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	64	28	$150.00	$76.82
99496 Transitional care management services for problem of high complexity	53	47	$352.10	$289.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	48	48	$248.50	$175.85
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	47	43	$348.94	$188.41
G0008 Administration of influenza virus vaccine	47	47	$50.00	$33.49
90661 Influenza vaccine, trivalent derived from cell cultures	46	46	$40.00	$35.33
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	34	19	$39.90	$15.19
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	33	18	$10.00	$1.26
99239 Hospital discharge day management, more than 30 minutes	26	25	$161.70	$118.33
99316 Nursing facility discharge management, more than 30 minutes	23	23	$158.90	$135.84
99495 Transitional care management services for problem of at least moderate complexity	20	18	$249.20	$218.13
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$204.40	$134.65
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	12	12	$312.20	$232.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,582	463	$250.00	$137.92
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	968	236	$288.62	$82.32
99213 Established patient office or other outpatient visit, typically 15 minutes	439	277	$150.00	$97.86
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	399	129	$199.21	$112.34
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	348	141	$290.74	$123.27
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	338	92	$150.00	$78.45
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	306	306	$250.00	$139.58
99238 Hospital discharge day management, 30 minutes or less	239	172	$107.49	$84.17
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	181	53	$200.00	$112.29
99497 Advance care planning, first 30 minutes	177	174	$122.50	$88.73
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	163	130	$346.72	$179.72
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	136	45	$150.00	$78.44
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	126	42	$199.76	$159.86
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	118	50	$204.40	$161.46
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	105	91	$201.06	$136.15
G0444 Annual depression screening, 5 to 15 minutes	88	88	$28.27	$20.42
99306 Initial nursing facility visit, typically 45 minutes per day	81	70	$249.90	$191.00
99496 Transitional care management services for problem of high complexity	62	52	$352.10	$296.76
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	56	56	$50.00	$33.49
G0008 Administration of influenza virus vaccine	56	56	$50.00	$32.87
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	55	30	$10.00	$1.54
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	54	29	$39.90	$15.50
99306 Initial nursing facility visit, typically 45 minutes per day	47	41	$246.86	$190.49
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	41	37	$195.30	$140.03
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	36	19	$350.00	$162.84
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$248.50	$180.03
99239 Hospital discharge day management, more than 30 minutes	31	30	$155.73	$119.53
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	26	23	$81.90	$56.93
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	20	18	$195.30	$140.20
99495 Transitional care management services for problem of at least moderate complexity	19	19	$249.20	$222.27

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,701	485	$215.86	$134.11
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	894	281	$121.26	$74.91
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	717	275	$124.42	$107.08
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	530	158	$173.73	$142.32
99213 Established patient office or other outpatient visit, typically 15 minutes	486	262	$130.53	$93.04
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	360	81	$169.64	$142.09
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	346	346	$246.13	$142.96
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	337	93	$200.00	$95.74
99238 Hospital discharge day management, 30 minutes or less	210	171	$83.51	$76.05
99497 Advance care planning, first 30 minutes	206	179	$105.85	$89.96
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	201	177	$238.90	$208.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	175	175	$170.05	$144.05
G0444 Annual depression screening, 5 to 15 minutes	159	159	$25.65	$20.49
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	148	124	$157.85	$141.30
99239 Hospital discharge day management, more than 30 minutes	147	128	$123.28	$111.57
99306 Initial nursing facility visit, typically 45 minutes per day	125	99	$224.15	$170.02
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	102	82	$63.70	$64.63
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	88	35	$193.94	$95.79
99496 Transitional care management services for problem of high complexity	74	60	$326.25	$287.85
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	68	25	$36.18	$15.99
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	67	25	$10.00	$1.71
G0008 Administration of influenza virus vaccine	55	53	$50.00	$32.53
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	52	47	$195.30	$135.13
99306 Initial nursing facility visit, typically 45 minutes per day	52	46	$216.89	$174.08
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	51	51	$50.00	$31.63
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	48	26	$150.00	$72.69
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	35	26	$67.20	$45.95
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	30	28	$81.13	$58.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$141.82	$119.60
99316 Nursing facility discharge management, more than 30 minutes	26	25	$127.37	$109.26
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	24	23	$195.30	$135.14
99495 Transitional care management services for problem of at least moderate complexity	21	21	$208.49	$197.21
99316 Nursing facility discharge management, more than 30 minutes	15	15	$158.90	$108.88
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	13	$61.64	$54.99
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	14	$280.89	$183.31
99497 Advance care planning, first 30 minutes	12	12	$122.50	$81.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	993	221	$130.89	$119.64
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	966	349	$119.78	$109.18
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	840	272	$46.58	$44.96
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	631	149	$149.91	$144.62
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	601	230	$101.45	$76.35
99213 Established patient office or other outpatient visit, typically 15 minutes	303	117	$84.97	$79.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	260	234	$234.28	$212.07
99239 Hospital discharge day management, more than 30 minutes	226	189	$120.33	$113.27
99306 Initial nursing facility visit, typically 45 minutes per day	202	138	$183.33	$177.56
99238 Hospital discharge day management, 30 minutes or less	160	140	$82.54	$77.21
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	122	40	$154.55	$144.60
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	112	101	$154.87	$144.47
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	95	38	$29.37	$15.80
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	80	36	$10.00	$2.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	62	62	$218.46	$142.13
99496 Transitional care management services for problem of high complexity	53	42	$255.22	$249.13
99491 Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month	43	40	$74.26	$74.98
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	42	42	$20.48	$19.91
G0008 Administration of influenza virus vaccine	42	42	$50.00	$18.83
G0444 Annual depression screening, 5 to 15 minutes	36	36	$19.59	$19.65
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	33	18	$209.27	$166.90
99497 Advance care planning, first 30 minutes	22	22	$83.57	$84.23
99306 Initial nursing facility visit, typically 45 minutes per day	22	20	$184.87	$177.53
99220 Hospital observation care, typically 70 minutes	19	19	$206.50	$192.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$108.25	$108.71
99316 Nursing facility discharge management, more than 30 minutes	14	12	$119.86	$112.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	1,867	336	$46.13	$45.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,044	219	$120.85	$115.99
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	753	221	$191.10	$76.70
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	392	93	$165.16	$144.65
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	372	174	$145.80	$111.25
99213 Established patient office or other outpatient visit, typically 15 minutes	295	128	$81.30	$75.60
99239 Hospital discharge day management, more than 30 minutes	209	178	$146.86	$114.84
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	145	70	$183.02	$144.39
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	141	127	$181.62	$146.12
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	125	115	$312.56	$215.95
99306 Initial nursing facility visit, typically 45 minutes per day	115	98	$228.75	$178.24
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	100	37	$28.52	$15.75
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	92	35	$10.00	$2.00
99238 Hospital discharge day management, 30 minutes or less	75	72	$100.42	$78.38
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	71	70	$20.00	$19.51
G0008 Administration of influenza virus vaccine	70	69	$50.00	$18.32
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	66	66	$165.92	$128.21
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	61	32	$172.35	$157.03
99306 Initial nursing facility visit, typically 45 minutes per day	61	52	$219.41	$178.59
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	58	26	$200.00	$98.20
G0444 Annual depression screening, 5 to 15 minutes	46	46	$17.46	$17.30
99496 Transitional care management services for problem of high complexity	39	34	$256.58	$247.72
99291 Critical care, first 30-74 minutes	31	13	$317.92	$234.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	20	$49.70	$48.31
99316 Nursing facility discharge management, more than 30 minutes	19	19	$134.93	$113.12
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	16	14	$64.53	$58.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$142.90	$129.43
99491 Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month	13	13	$74.26	$75.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	2,451	374	$46.52	$44.46
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	1,563	275	$92.77	$76.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,349	268	$162.83	$115.67
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	637	109	$199.90	$97.17
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	320	232	$152.76	$143.88
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	314	118	$115.51	$107.56
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	239	66	$187.22	$97.13
99239 Hospital discharge day management, more than 30 minutes	201	172	$119.79	$113.45
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	168	62	$30.93	$18.16
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	162	61	$9.94	$1.79
99238 Hospital discharge day management, 30 minutes or less	145	125	$81.29	$77.06
99291 Critical care, first 30-74 minutes	129	45	$310.64	$233.05
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	122	115	$234.91	$212.82
99306 Initial nursing facility visit, typically 45 minutes per day	121	96	$228.62	$176.17
99220 Hospital observation care, typically 70 minutes	113	99	$205.87	$195.28
99213 Established patient office or other outpatient visit, typically 15 minutes	109	54	$86.51	$78.76
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	95	95	$147.16	$124.06
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	91	48	$172.27	$143.63
G0444 Annual depression screening, 5 to 15 minutes	83	83	$22.04	$19.64
99226 Subsequent observation care, typically 35 minutes per day	74	65	$150.84	$109.19
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	71	44	$187.10	$143.65
99496 Transitional care management services for problem of high complexity	69	53	$273.31	$248.91
G0008 Administration of influenza virus vaccine	68	64	$50.00	$17.98
99306 Initial nursing facility visit, typically 45 minutes per day	65	48	$228.99	$176.18
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	58	44	$259.92	$155.57
99225 Subsequent observation care, typically 25 minutes per day	53	33	$80.56	$75.49
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	45	45	$20.00	$18.65
99217 Hospital observation care on day of discharge	45	41	$82.33	$77.38
99497 Advance care planning, first 30 minutes	37	37	$100.74	$88.05
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	35	35	$32.04	$27.53
99497 Advance care planning, first 30 minutes	29	29	$114.05	$83.35
99495 Transitional care management services for problem of at least moderate complexity	26	25	$205.35	$176.40
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	26	26	$62.30	$57.38
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	23	21	$38.03	$27.38
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	22	21	$103.34	$99.40
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	22	20	$20.00	$17.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	13	$49.60	$47.41
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	20	20	$238.08	$176.87
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$167.83	$138.79
99316 Nursing facility discharge management, more than 30 minutes	17	17	$148.18	$111.78
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	12	12	$295.89	$211.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	2,098	370	$56.67	$44.96
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,080	312	$272.68	$76.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,221	254	$222.78	$114.71
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	541	89	$198.37	$96.94
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	406	277	$199.22	$142.33
99238 Hospital discharge day management, 30 minutes or less	383	273	$106.58	$77.03
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	245	68	$9.49	$1.88
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	245	66	$37.37	$22.43
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	245	89	$192.41	$96.89
99213 Established patient office or other outpatient visit, typically 15 minutes	227	79	$117.33	$78.10
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	212	68	$143.87	$73.50
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	175	65	$139.59	$101.71
99291 Critical care, first 30-74 minutes	169	63	$391.37	$232.34
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	139	77	$344.43	$154.27
99220 Hospital observation care, typically 70 minutes	126	102	$270.30	$195.59
99306 Initial nursing facility visit, typically 45 minutes per day	113	89	$246.10	$173.86
99219 Hospital observation care, typically 50 minutes	108	66	$198.70	$142.78
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	101	41	$127.66	$73.42
99496 Transitional care management services for problem of high complexity	98	63	$323.33	$248.86
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	93	93	$251.60	$182.48
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	83	38	$200.88	$143.95
G0008 Administration of influenza virus vaccine	77	74	$50.00	$22.32
G0444 Annual depression screening, 5 to 15 minutes	75	75	$25.98	$19.26
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	72	72	$20.28	$17.48
99217 Hospital observation care on day of discharge	68	52	$106.46	$77.23
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	68	61	$326.40	$208.91
99218 Hospital observation care typically 30 minutes	58	36	$145.49	$103.46
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	48	29	$197.09	$143.98
99306 Initial nursing facility visit, typically 45 minutes per day	45	39	$246.72	$173.69
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	44	44	$136.73	$122.42
99495 Transitional care management services for problem of at least moderate complexity	40	35	$238.51	$176.22
94060 Test to measure expiratory airflow and volume changes before and after medication administration	26	25	$87.42	$67.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	13	$60.39	$47.28
99315 Nursing facility discharge day management, 30 minutes or less	19	19	$109.90	$76.94
99497 Advance care planning, first 30 minutes	18	18	$105.00	$87.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$186.38	$146.88
99497 Advance care planning, first 30 minutes	16	16	$122.50	$83.20
20550 Injection into tendon or ligament	15	12	$71.30	$56.80
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	15	15	$75.72	$57.75
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	13	13	$13.30	$9.49
99239 Hospital discharge day management, more than 30 minutes	13	13	$151.02	$113.54
93880 Ultrasound of both sides of head and neck blood flow	13	13	$256.02	$222.04
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	13	13	$12.60	$8.89
92548 Assessment of balance and postural instability	11	11	$135.81	$109.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	1,788	287	$243.65	$73.49
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	923	210	$208.59	$110.69
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	512	219	$62.93	$43.43
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	369	248	$248.72	$138.85
99238 Hospital discharge day management, 30 minutes or less	332	235	$118.21	$74.29
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	270	63	$196.78	$93.70
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	186	52	$148.83	$70.98
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	141	40	$120.97	$70.85
99220 Hospital observation care, typically 70 minutes	139	118	$308.84	$189.40
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	121	60	$11.95	$2.38
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	117	58	$39.21	$27.11
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	114	54	$184.83	$93.70
99291 Critical care, first 30-74 minutes	113	43	$429.32	$226.62
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	105	51	$183.60	$106.28
99219 Hospital observation care, typically 50 minutes	100	93	$232.62	$137.65
99213 Established patient office or other outpatient visit, typically 15 minutes	99	72	$135.14	$75.90
99218 Hospital observation care typically 30 minutes	98	54	$167.04	$101.50
99217 Hospital observation care on day of discharge	82	70	$143.21	$74.64
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	69	69	$258.78	$176.82
G0008 Administration of influenza virus vaccine	64	64	$44.63	$27.41
99496 Transitional care management services for problem of high complexity	57	43	$361.60	$239.98
G0444 Annual depression screening, 5 to 15 minutes	51	51	$27.72	$18.90
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	41	41	$201.79	$120.33
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	36	31	$356.67	$202.89
99306 Initial nursing facility visit, typically 45 minutes per day	29	25	$242.50	$170.25
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	26	22	$323.89	$149.52
99306 Initial nursing facility visit, typically 45 minutes per day	23	19	$263.27	$170.25
93880 Ultrasound of both sides of head and neck blood flow	21	20	$292.67	$213.49
99495 Transitional care management services for problem of at least moderate complexity	21	20	$254.86	$169.85
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	18	14	$83.91	$56.07
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	17	17	$50.00	$23.57
99231 Follow-up hospital inpatient care per day, typically 15 minutes	16	13	$94.50	$39.93
99497 Advance care planning, first 30 minutes	12	12	$119.58	$83.51
99315 Nursing facility discharge day management, 30 minutes or less	12	11	$119.20	$75.16
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	12	12	$195.30	$133.15

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License NJ MA68270

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

7980906 (NJ)

Commercial Insurance / Payer ID Cds

DO75091 (NJ)

Commercial Insurance / Payer ID Nj License Number

MA68270 (NJ)

Hospital & Practice Group Affiliations

Botox And Family Associates Llc

20 Hospital Dr, Toms River, NJ 087556434

Phone: 7323419900

Ocean Family And Geriatric Associates Llc

20 Hospital Dr, Toms River, NJ 087556434

Phone: 7323419900

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Cathrene Suobiron , APN

Nurse Practitioner - Primary Care

NPI 1295400943

Advanced Practice Nurse

Sonnet Tolentino

Nurse Practitioner - Gerontology

NPI 1336906379

Charles Dume , APN

Nurse Practitioner - Primary Care

NPI 1992656631

Advanced Practice Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active May 12, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location May 12, 2017

Registered at 20 HOSPITAL DR, STE 3, TOMS RIVER, NJ 087556434 (Tel: 7323419900)

📍

Updated Business Mailing Address May 12, 2017

Registered at 20 HOSPITAL DR, STE 3, TOMS RIVER, NJ 087556434 (Tel: 7323419900)

👤

Provider Name / Credentials Updated May 12, 2017

Recorded as PRABHAT SINHA, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 12, 2017

Internal Medicine (License #MA68270 in NJ)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 20 HOSPITAL DR, SUITE - 3, TOMS RIVER, NJ 087556434 (Tel: 7323419900)

📍

Updated Business Mailing Address July 08, 2007

Registered at 653 LOXLEY DR, TOMS RIVER, NJ 087534385 (Tel: 7323419900)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as PRABHAT SINHA, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Internal Medicine (License #MA68270 in NJ)

🟢

Initial NPI Registration & Enumeration January 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1013988286

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 27, 2006

Last Update: May 12, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

20 Hospital Dr, Ste 3

Toms River, NJ 087556434

Phone: 7323419900

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.