Physician

Adrian James Ptacek, M.D.

According to 2025 Medicare claims, Adrian Ptacek, M.D. (NPI: 1528418670) practices pediatric medicine in the Grand Rapids-Wyoming-Kentwood, MI market, with the plurality of this provider's patient population coming from Kent, MI. This provider's primary affiliated billing organization is SPECTRUM HEALTH PRIMARY CARE PARTNERS (NPI: 1235188673; TIN: 381358164) and primary practice location at 49525-8614. Ptacek is affiliated with the West Michigan Accountable Care Organization, LLC (ACO ID: A4626), participating under the MSSP model.

Ptacek's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 64 traditional Medicare patients, billed 180 HCPCS/CPT codes, and received $13,958 in Medicare payments. The top billing code was G0439 (Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit). Part D data shows 2,779 prescription claims across 313 beneficiaries totaling $260,259 in drug costs, led by Eliquis (Apixaban). DME data shows 24 claims. Open Payments data shows 3 records totaling $50. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing did not follow a clear longitudinal pattern. Concurrently, Part D prescription costs have risen steadily, from $3,370 to $260,259. In contrast, DME billing represents a smaller volume and moved sharply higher in recent years, from $451 to $1,082.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	37	97	$5,543
2021	76	203	$11,174
2022	83	210	$10,770
2023	79	391	$10,537
2024	64	180	$13,958

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	N/R	N/R	N/R
2016	13	23	$3,370
2017	22	138	$10,387
2018	24	288	$55,363
2019	24	208	$30,663
2020	107	301	$39,730
2021	263	1,497	$111,434
2022	301	2,101	$184,134
2023	340	2,920	$258,622
2024	313	2,779	$260,259

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	N/R	12	$179
2021	N/R	24	$2,907
2022	N/R	N/R	N/R
2023	N/R	N/R	N/R
2024	N/R	24	$3,191

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	35	35	$131
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	51	61	$59
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	29	37	$49

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	35	2,790	$50,895
Jardiance	Empagliflozin	28	2,446	$46,146
Mounjaro	Tirzepatide	26	1,008	$35,133
Trulicity	Dulaglutide	20	728	$23,714
Ozempic	Semaglutide	13	394	$11,968

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	N	N/R	12	$1,731
B4150	Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	N	N/R	12	$1,460

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	3	$50	Abbott Laboratories
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

Explore More Providers

FAQ

What Medicare data is available for Adrian James Ptacek, M.D.?

Tedicare shows public-source Medicare data for Adrian James Ptacek, M.D. (NPI 1528418670), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Adrian James Ptacek, M.D. have ACO affiliation data?

Adrian James Ptacek, M.D. is shown with ACO affiliation data for West Michigan Accountable Care Organization, LLC (MSSP, ACO ID A4626).

What billing organization is linked to Adrian James Ptacek, M.D.?

Adrian James Ptacek, M.D. is linked to SPECTRUM HEALTH PRIMARY CARE PARTNERS (billing NPI 1235188673) in the available physician profile data.

Does Adrian James Ptacek, M.D. have Open Payments data?

Adrian James Ptacek, M.D. has 3 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.