Sims, Herbert

Sims, Herbert was paid $315K by Medicaid between Apr 2018 and Nov 2024, across 4 billing codes. Its largest line is 31579, — 85% of everything it billed.

33Billing provider infoSIMS, HERBERT
CHICAGO, IL 60612

33aNPI1295748499assigned 08/15/2006

33bProvider typeOtolaryngology Physician

28Total paid$315K

24GClaims2,759

24DCodes billed4

24AFirst – last monthApr 2018 – Nov 2024

Compared with peers

Next to other Otolaryngology Physician providers in Illinois

Rank by total paid#16 of 221

Median peer was paid$21K

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
2018	101	$15K
2019	340	$66K
2020	146	$28K
2021	510	$46K
2022	579	$49K
2023	680	$71K
2024incomplete	403	$40K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
31579		85%	1,575	1,391	$269K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	13%	1,070	873	$40K
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	1.4%	77	65	$4K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	37	25	$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.