Downes, Robert

Downes, Robert was paid $169K by Medicaid between Jan 2018 and Dec 2021, across 5 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 69% of everything it billed.

33Billing provider infoDOWNES, ROBERT
NATICK, MA 01760

33aNPI1235165291assigned 06/23/2006

33bProvider typeAddiction Medicine (Internal Medicine) Physician

28Total paid$169K

24GClaims2,782

24DCodes billed5

24AFirst – last monthJan 2018 – Dec 2021

Compared with peers

Next to other Addiction Medicine (Internal Medicine) Physician providers in Massachusetts

Rank by total paid#7 of 12

Median peer was paid$169K

This provider vs. median1.0×

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	977	$55K
2019	922	$56K
2020	710	$50K
2021	173	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	69%	1,352	1,068	$116K
90836		26%	1,273	1,017	$45K
90834	Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient	2.3%	47	40	$4K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	1.5%	78	71	$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	1.2%	32	27	$2K

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.