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Dr. Matthew  Karulf  Md image

Dr. Matthew Karulf Md

4100 Lake Dr Se Suite 200
Grand Rapids MI 49546
616 678-8244
Medical School: University Of Colorado School Of Medicine - 2001
Accepts Medicare: No
Participates In eRX: Yes
Participates In PQRS: No
Participates In EHR: No
License #:
NPI: 1912109083
Taxonomy Codes:
207RP1001X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Matthew Karulf is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:31624 Description:Dx bronchoscope/lavage Average Price:$415.67 Average Price Allowed
By Medicare:
$87.97
HCPCS Code:36556 Description:Insert non-tunnel cv cath Average Price:$414.80 Average Price Allowed
By Medicare:
$121.19
HCPCS Code:99291 Description:Critical care first hour Average Price:$456.18 Average Price Allowed
By Medicare:
$213.92
HCPCS Code:99205 Description:Office/outpatient visit new Average Price:$312.25 Average Price Allowed
By Medicare:
$159.82
HCPCS Code:99204 Description:Office/outpatient visit new Average Price:$235.00 Average Price Allowed
By Medicare:
$124.70
HCPCS Code:99215 Description:Office/outpatient visit est Average Price:$213.80 Average Price Allowed
By Medicare:
$105.19
HCPCS Code:99292 Description:Critical care addl 30 min Average Price:$206.43 Average Price Allowed
By Medicare:
$107.32
HCPCS Code:99223 Description:Initial hospital care Average Price:$281.63 Average Price Allowed
By Medicare:
$191.89
HCPCS Code:99214 Description:Office/outpatient visit est Average Price:$148.00 Average Price Allowed
By Medicare:
$74.80
HCPCS Code:36620 Description:Insertion catheter artery Average Price:$119.40 Average Price Allowed
By Medicare:
$50.95
HCPCS Code:99233 Description:Subsequent hospital care Average Price:$148.90 Average Price Allowed
By Medicare:
$98.20
HCPCS Code:99232 Description:Subsequent hospital care Average Price:$105.70 Average Price Allowed
By Medicare:
$68.44
HCPCS Code:99231 Description:Subsequent hospital care Average Price:$59.20 Average Price Allowed
By Medicare:
$37.43
HCPCS Code:76937 Description:Us guide vascular access Average Price:$33.69 Average Price Allowed
By Medicare:
$14.76

HCPCS Code Definitions

99233
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
36556
Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older
31624
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage
99205
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99204
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99232
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
36620
Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous
76937
Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (List separately in addition to code for primary procedure)
99231
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering or improving. Typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
99215
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99223
Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99292
Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service)
99291
Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1093792574
Internal Medicine
995
1760422786
Pulmonary Disease
803
1700826880
Pulmonary Disease
682
1831118744
Interventional Radiology
640
1215938303
Hematology/Oncology
564
1174700256
Hematology/Oncology
522
1942292792
Diagnostic Radiology
485
1629001185
Diagnostic Radiology
482
1942289798
Cardiovascular Disease (Cardiology)
475
1891735981
Pulmonary Disease
471
*These referrals represent the top 10 that Dr. Karulf has made to other doctors

Publications

OX40 ligand regulates inflammation and mortality in the innate immune response to sepsis. - Journal of immunology (Baltimore, Md. : 1950)
The initial phase of sepsis is characterized by massive inflammatory cytokine production that contributes to multisystem organ failure and death. Costimulatory molecules are a class of receptors capable of regulating cytokine production in adaptive immunity. Recent studies described their presence on neutrophils and monocytes, suggesting a potential role in the regulation of cytokine production in innate immunity. The purpose of this study was to determine the role for OX40-OX40 ligand (OX40L) interaction in the innate immune response to polymicrobial sepsis. Humans with sepsis demonstrated upregulation of OX40L on monocytes and neutrophils, with mortality and intensive care unit stay correlating with expression levels. In an animal model of polymicrobial sepsis, a direct role for OX40L in regulating inflammation was indicated by improved survival, decreased cytokine production, and a decrease in remote organ damage in OX40L(-/-) mice. The finding of similar results with an OX40L Ab suggests a potential therapeutic role for OX40L blockade in sepsis. The inability of anti-OX40L to provide significant protection in macrophage-depleted mice establishes macrophages as an indispensable cell type within the OX40/OX40L axis that helps to mediate the clinical signs of disease in sepsis. Conversely, the protective effect of anti-OX40L Ab in RAG1(-/-) mice further confirms a T cell-independent role for OX40L stimulation in sepsis. In conclusion, our data provide an in vivo role for the OX40/OX40L system in the innate immune response during polymicrobial sepsis and suggests a potential beneficial role for therapeutic blockade of OX40L in this devastating disorder.
Differential role for CD80 and CD86 in the regulation of the innate immune response in murine polymicrobial sepsis. - PloS one
Inflammation in the early stages of sepsis is governed by the innate immune response. Costimulatory molecules are a receptor/ligand class of molecules capable of regulation of inflammation in innate immunity via macrophage/neutrophil contact. We recently described that CD80/86 ligation is required for maximal macrophage activation and CD80/86(-/-) mice display reduced mortality and inflammatory cytokine production after cecal ligation and puncture (CLP). However, these data also demonstrate differential regulation of CD80 and CD86 expression in sepsis, suggesting a divergent role for these receptors. Therefore, the goal of this study was to determine the individual contribution of CD80/86 family members in regulating inflammation in sepsis.CD80(-/-) mice had improved survival after CLP when compared to WT or CD86(-/-) mice. This was associated with preferential attenuation of inflammatory cytokine production in CD80(-/-) mice. Results were confirmed with pharmacologic blockade, with anti-CD80 mAb rescuing mice when administered before or after CLP. In vitro, activation of macrophages with neutrophil lipid rafts caused selective disassociation of IRAK-M, a negative regulator of NF-kappaB signaling from CD80; providing a mechanism for preferential regulation of cytokine production by CD80. Finally, in humans, upregulation of CD80 and loss of constitutive CD86 expression on monocytes was associated with higher severity of illness and inflammation confirming the findings in our mouse model.In conclusion, our data describe a differential role for CD80 and CD86 in regulation of inflammation in the innate immune response to sepsis. Future therapeutic strategies for blockade of the CD80/86 system in sepsis should focus on direct inhibition of CD80.

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4100 Lake Dr Se Suite 200 Grand Rapids, MI 49546
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