Physician
Sutton, Brian Paul
Sutton, Brian Paul was paid $214K by Medicaid between Jun 2018 and Mar 2023, across 12 billing codes. Its largest line is 99203, doctor's office visit, new patient (routine) — 38% of everything it billed.
33Billing provider infoSUTTON, BRIAN PAUL
WESTFIELD, MA 01085
WESTFIELD, MA 01085
33aNPI1073552501assigned 06/06/2006
33bProvider typeEmergency Medicine Physician
28Total paid$214K
24GClaims4,087
24DCodes billed12
24AFirst – last monthJun 2018 – Mar 2023
Compared with peers
Next to other Emergency Medicine Physician providers in Massachusetts
Rank by total paid#60 of 618
Median peer was paid$8K
This provider vs. median26×
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 | 16 | $887.53 | |
| 2019 | 397 | $18K | |
| 2020 | 331 | $17K | |
| 2021 | 1,404 | $82K | |
| 2022 | 1,622 | $82K | |
| 2023 | 317 | $14K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 38% | 1,083 | 1,081 | $81K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 32% | 1,335 | 1,221 | $68K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 19% | 797 | 742 | $41K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 6.2% | 183 | 170 | $13K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.5% | 102 | 92 | $3K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 258 | 253 | $3K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.1% | 200 | 188 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 35 | 35 | $2K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 29 | 29 | $446.89 |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 32 | 29 | $350.40 |
| 99051 | <1% | 12 | 12 | $149.04 | |
| 94760 | 0% | 21 | 21 | $0.00 |
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.