Physician
Rummel, James
Rummel, James was paid $257K by Medicaid between Feb 2018 and Jul 2023, across 6 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.
33Billing provider infoRUMMEL, JAMES
SHARON, PA 16146
SHARON, PA 16146
33aNPI1346520525assigned 08/19/2011
33bProvider typeFamily Medicine Physician
28Total paid$257K
24GClaims2,981
24DCodes billed6
24AFirst – last monthFeb 2018 – Jul 2023
Compared with peers
Next to other Family Medicine Physician providers in Pennsylvania
Rank by total paid#281 of 2,756
Median peer was paid$19K
This provider vs. median13×
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 | 31 | $836.73 | |
| 2019 | 40 | $384.59 | |
| 2020 | 12 | $668.15 | |
| 2021 | 1,112 | $86K | |
| 2022 | 1,223 | $107K | |
| 2023 | 563 | $61K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 99% | 1,436 | 1,279 | $255K |
| 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% | 567 | 551 | $2K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 0% | 519 | 487 | $0.00 |
| 3008F | 0% | 406 | 387 | $0.00 | |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 0% | 26 | 24 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 27 | 27 | $0.00 |
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.