Whalen, James

Whalen, James was paid $244K by Medicaid between Oct 2018 and Sep 2024, across 4 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 80% of everything it billed.

33Billing provider infoWHALEN, JAMES
LINCOLN, RI 02865

33aNPI1134245954assigned 03/22/2007

33bProvider typePsychiatry Physician

28Total paid$244K

24GClaims2,583

24DCodes billed4

24AFirst – last monthOct 2018 – Sep 2024

Compared with peers

Next to other Psychiatry Physician providers in Rhode Island

Rank by total paid#26 of 140

Median peer was paid$50K

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	79	$7K
2019	187	$19K
2020	1,079	$97K
2021	788	$68K
2023	175	$20K
2024incomplete	275	$33K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	80%	1,988	1,707	$195K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	10%	174	158	$25K
90833	Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on)	8.3%	364	326	$20K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.4%	57	53	$3K

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.