Sample, James

Sample, James was paid $187K by Medicaid between Oct 2020 and Dec 2023, across 4 billing codes. Its largest line is 99285, emergency room visit (most serious) — 53% of everything it billed.

33Billing provider infoSAMPLE, JAMES
GREENSBURG, PA 15601

33aNPI1255307435assigned 02/27/2006

33bProvider typeEmergency Medicine Physician

28Total paid$187K

24GClaims3,818

24DCodes billed4

24AFirst – last monthOct 2020 – Dec 2023

Compared with peers

Next to other Emergency Medicine Physician providers in Pennsylvania

Rank by total paid#158 of 1,211

Median peer was paid$19K

This provider vs. median9.6×

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
2020	197	$8K
2021	1,247	$48K
2022	1,258	$50K
2023	1,116	$81K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	53%	1,550	1,526	$100K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	32%	967	959	$60K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	11%	585	576	$21K
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	2.7%	716	707	$5K

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.