Physician
Hertenstein, James
Hertenstein, James was paid $14K by Medicaid between May 2019 and May 2020, across 3 billing codes. Its largest line is 99203, doctor's office visit, new patient (routine) — 67% of everything it billed.
33Billing provider infoHERTENSTEIN, JAMES
PEORIA, IL 61615
PEORIA, IL 61615
33aNPI1295707578assigned 02/02/2006
28Total paid$14K
24GClaims433
24DCodes billed3
24AFirst – last monthMay 2019 – May 2020
Compared with peers
Next to other Plastic Surgery within the Head & Neck (Otolaryngology) Physician providers in Illinois
Rank by total paid#9 of 11
Median peer was paid$26K
This provider vs. median0.5×
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 | |
|---|---|---|---|
| 2019 | 322 | $11K | |
| 2020 | 111 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 67% | 242 | 237 | $9K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 30% | 166 | 158 | $4K |
| 69210 | 3.2% | 25 | 25 | $442.79 |
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.