Physician
Tom Mcdonald MD PLLC
Tom Mcdonald MD PLLC was paid $54K by Medicaid between Jan 2018 and May 2021, across 11 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 57% of everything it billed.
33Billing provider infoTOM MCDONALD MD PLLC
LEXINGTON, TN 38351
LEXINGTON, TN 38351
33aNPI1235561291assigned 08/01/2013
33bProvider typeInternal Medicine Physician
28Total paid$54K
24GClaims3,385
24DCodes billed11
24AFirst – last monthJan 2018 – May 2021
Compared with peers
Next to other Internal Medicine Physician providers in Tennessee
Rank by total paid#185 of 581
Median peer was paid$15K
This provider vs. median3.6×
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 | 1,532 | $22K | |
| 2019 | 1,162 | $18K | |
| 2020 | 527 | $10K | |
| 2021 | 164 | $4K |
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 | 57% | 1,562 | 1,195 | $31K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 33% | 876 | 714 | $18K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 8.0% | 339 | 257 | $4K |
| 80305 | 1.1% | 221 | 142 | $584.64 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 289 | 219 | $216.36 |
| 90688 | <1% | 20 | 17 | $117.51 | |
| 90686 | <1% | 20 | 15 | $103.35 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 15 | 12 | $88.80 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 14 | 12 | $53.10 |
| 81003 | <1% | 15 | 12 | $14.67 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 14 | 12 | $0.85 |
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.
From NPPES
Who's on the registration
Authorized officialMCDONALD, THOMAS (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Thomas J Mcdonald DDS PC | Mount Pleasant, MI | $360K |
| Mcdonald Oral and Maxillofacial Surgery, LLC | Florence, SC | $227K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.