Helton, Harold

Helton, Harold was paid $257K by Medicaid between Jan 2018 and Nov 2024, across 7 billing codes. Its largest line is 90960, End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits — 83% of everything it billed.

33Billing provider infoHELTON, HAROLD
SOMERSET, KY 42503

33aNPI1063404481assigned 08/22/2005

33bProvider typeNephrology Physician

28Total paid$257K

24GClaims6,634

24DCodes billed7

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Nephrology Physician providers in Kentucky

Rank by total paid#7 of 25

Median peer was paid$52K

This provider vs. median4.9×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	1,153	$58K
2019	1,192	$52K
2020	1,284	$52K
2021	1,161	$36K
2022	860	$27K
2023	628	$18K
2024incomplete	356	$14K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90960	End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits	83%	4,865	3,611	$214K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	14%	1,506	1,190	$37K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	1.1%	88	28	$3K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	131	94	$2K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	<1%	15	13	$694.56
99223	Prolong inpt eval add15 m	<1%	13	12	$514.88
90961		<1%	16	12	$279.61

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.