Physician
Sutton, John
Sutton, John was paid $290K by Medicaid between Nov 2020 and Aug 2024, across 12 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 72% of everything it billed.
33Billing provider infoSUTTON, JOHN
WARREN, PA 16365
WARREN, PA 16365
33aNPI1164490025assigned 03/08/2006
33bProvider typeFamily Medicine Physician
28Total paid$290K
24GClaims9,136
24DCodes billed12
24AFirst – last monthNov 2020 – Aug 2024
Compared with peers
Next to other Family Medicine Physician providers in Pennsylvania
Rank by total paid#245 of 2,756
Median peer was paid$19K
This provider vs. median15×
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 | 208 | $7K | |
| 2021 | 2,452 | $86K | |
| 2022 | 2,409 | $83K | |
| 2023 | 3,691 | $102K | |
| 2024incomplete | 376 | $11K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 72% | 6,216 | 5,655 | $208K |
| 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 | 25% | 1,516 | 1,472 | $73K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.3% | 151 | 144 | $4K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.0% | 458 | 446 | $3K |
| 81002 | <1% | 132 | 128 | $465.70 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 29 | 29 | $319.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 12 | 12 | $264.00 |
| 90686 | <1% | 18 | 17 | $176.00 | |
| 3078F | 0% | 245 | 238 | $0.00 | |
| 3077F | 0% | 14 | 14 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 13 | 13 | $0.00 |
| 3008F | 0% | 332 | 323 | $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.