Clinic
Jim J. Gould, MD PC
Jim J. Gould, MD PC was paid $1.16M by Medicaid between Jan 2018 and Oct 2024, across 40 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 42% of everything it billed.
33Billing provider infoJIM J. GOULD, MD PC
TOOELE, UT 84074
TOOELE, UT 84074
33aNPI1366719015assigned 11/23/2011
33bProvider typeClinic/Center
28Total paid$1.16M
24GClaims33,003
24DCodes billed40
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Clinic/Center providers in Utah
Rank by total paid#8 of 35
Median peer was paid$160K
This provider vs. median7.3×
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 | 6,303 | $217K | |
| 2019 | 5,416 | $192K | |
| 2020 | 4,815 | $177K | |
| 2021 | 6,647 | $221K | |
| 2022 | 4,830 | $195K | |
| 2023 | 2,831 | $91K | |
| 2024incomplete | 2,161 | $66K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 42% | 7,955 | 6,928 | $482K |
| 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 | 20% | 2,960 | 2,722 | $232K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 14% | 1,708 | 1,623 | $168K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 13% | 1,638 | 1,479 | $151K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.6% | 850 | 772 | $65K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.4% | 351 | 290 | $28K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,855 | 3,567 | $10K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,110 | 1,959 | $5K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 2,553 | 2,333 | $3K |
| 36416 | <1% | 330 | 311 | $3K | |
| 90686 | <1% | 1,135 | 1,082 | $2K | |
| 90670 | <1% | 1,290 | 1,161 | $2K |
28 more codes
| 99381 | <1% | 52 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 26 | $1K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 15 | $1K |
| 90461 | <1% | 110 | $856.22 | |
| 87430 | <1% | 66 | $763.75 | |
| 87807 | <1% | 160 | $647.45 | |
| 90674 | <1% | 110 | $436.34 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 194 | $428.12 |
| 90633 | <1% | 519 | $422.32 | |
| 90744 | <1% | 459 | $370.53 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 553 | $313.36 |
| 90651 | <1% | 144 | $312.17 | |
| 90698 | <1% | 1,318 | $203.43 | |
| 83655 | <1% | 107 | $169.41 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 139 | $165.53 |
| 90680 | <1% | 708 | $128.63 | |
| 96127 | <1% | 75 | $76.89 | |
| 85018 | <1% | 91 | $23.31 | |
| 90710 | <1% | 395 | $0.05 | |
| 90696 | <1% | 63 | $0.02 | |
| 90697 | <1% | 109 | $0.02 | |
| 90671 | <1% | 162 | $0.02 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 0% | 135 | $0.00 |
| 90474 | 0% | 44 | $0.00 | |
| 90734 | 0% | 94 | $0.00 | |
| 90715 | 0% | 81 | $0.00 | |
| 90473 | 0% | 214 | $0.00 | |
| 99173 | 0% | 125 | $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 officialGOULD, JIM (OWNER)