Physician
Balmer, John
Balmer, John was paid $1.93M by Medicaid between Sep 2020 and Dec 2024, across 23 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.
33Billing provider infoBALMER, JOHN
SPARTANSBURG, PA 16434
SPARTANSBURG, PA 16434
33aNPI1104912476assigned 10/05/2006
33bProvider typeFamily Medicine Physician
28Total paid$1.93M
24GClaims38,754
24DCodes billed23
24AFirst – last monthSep 2020 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Pennsylvania
Rank by total paid#32 of 2,756
Median peer was paid$19K
This provider vs. median100×
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 | |
|---|---|---|---|
| 2020 | 1,149 | $55K | |
| 2021 | 8,879 | $414K | |
| 2022 | 8,644 | $436K | |
| 2023 | 10,509 | $525K | |
| 2024incomplete | 9,573 | $497K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 100% | 17,813 | 15,522 | $1.93M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | <1% | 17 | 17 | $935.00 |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | <1% | 15 | 15 | $577.50 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 301 | 301 | $166.80 |
| 3075F | 0% | 2,132 | 2,050 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 375 | 371 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 1,412 | 1,376 | $0.00 |
| 3074F | 0% | 5,859 | 5,386 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 13 | 13 | $0.00 |
| 3079F | 0% | 3,027 | 2,886 | $0.00 | |
| 92551 | 0% | 565 | 565 | $0.00 | |
| 99406 | 0% | 58 | 56 | $0.00 |
11 more codes
| 90733 | 0% | 25 | $0.00 | |
| 90656 | 0% | 12 | $0.00 | |
| 3078F | 0% | 6,195 | $0.00 | |
| 99173 | 0% | 575 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 82 | $0.00 |
| 90461 | 0% | 66 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 89 | $0.00 |
| 81002 | 0% | 54 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 31 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 13 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 25 | $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.