Physician
Toledo Pain Services, PLL
Toledo Pain Services, PLL was paid $2.33M by Medicaid between Jan 2018 and Dec 2024, across 34 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 45% of everything it billed.
33Billing provider infoTOLEDO PAIN SERVICES, PLL
TOLEDO, OH 43617
TOLEDO, OH 43617
33aNPI1356339857assigned 10/10/2005
33bProvider typeInterventional Pain Medicine Physician
28Total paid$2.33M
24GClaims103,238
24DCodes billed34
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Interventional Pain Medicine Physician providers in Ohio
Rank by total paid#1 of 24
Median peer was paid$20K
This provider vs. median115×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official JAMES, WILLIAM controls 11+ related entities in our dataset. Read more
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 | 19,853 | $428K | |
| 2019 | 2,007 | $38K | |
| 2020 | 20,072 | $436K | |
| 2021 | 18,023 | $394K | |
| 2022 | 17,599 | $433K | |
| 2023 | 14,789 | $306K | |
| 2024incomplete | 10,895 | $291K |
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 | 45% | 28,954 | 26,045 | $1.04M |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 24% | 20,775 | 5,353 | $553K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.6% | 7,617 | 6,884 | $176K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 7.4% | 6,052 | 5,584 | $173K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 6.3% | 20,314 | 5,295 | $147K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 4.1% | 12,589 | 3,422 | $95K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 1.7% | 771 | 679 | $40K |
| 97032 | <1% | 905 | 306 | $22K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 379 | 344 | $21K |
| 64635 | <1% | 181 | 150 | $10K | |
| 62323 | <1% | 133 | 122 | $8K | |
| 96101 | <1% | 174 | 155 | $5K |
22 more codes
| 97162 | <1% | 123 | $5K | |
| 64483 | <1% | 125 | $4K | |
| 64636 | <1% | 148 | $4K | |
| 90837 | Psychotherapy session, about an hour | <1% | 76 | $3K |
| 97014 | <1% | 913 | $3K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 1,786 | $3K |
| 97161 | <1% | 129 | $2K | |
| 62321 | <1% | 30 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 109 | $2K |
| 27096 | <1% | 15 | $2K | |
| 99205 | Prolong outpt/office vis | <1% | 14 | $1K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 20 | $695.96 |
| 20610 | <1% | 31 | $647.52 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 67 | $584.47 |
| 97116 | <1% | 46 | $541.91 | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | <1% | 532 | $427.47 |
| 96130 | <1% | 15 | $296.27 | |
| 97150 | Therapeutic procedure(s), group (2 or more individuals) | <1% | 85 | $230.33 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 37 | $229.20 |
| 96102 | <1% | 40 | $177.72 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 21 | $3.92 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 32 | $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.
From NPPES
Who's on the registration
Authorized officialJAMES, WILLIAM (MEDICAL DIRECTOR)
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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.