NP / PA
Kacsmar, Michael
Kacsmar, Michael was paid $80K by Medicaid between Oct 2020 and Dec 2024, across 12 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 52% of everything it billed.
33Billing provider infoKACSMAR, MICHAEL
DU BOIS, PA 15801
DU BOIS, PA 15801
33aNPI1427282706assigned 05/14/2009
33bProvider typeFamily Nurse Practitioner
28Total paid$80K
24GClaims3,745
24DCodes billed12
24AFirst – last monthOct 2020 – Dec 2024
Compared with peers
Next to other Family Nurse Practitioner providers in Pennsylvania
Rank by total paid#165 of 1,075
Median peer was paid$8K
This provider vs. median9.5×
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 | |
|---|---|---|---|
| 2020 | 330 | $14K | |
| 2021 | 238 | $9K | |
| 2022 | 495 | $12K | |
| 2023 | 1,327 | $26K | |
| 2024incomplete | 1,355 | $18K |
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 | 52% | 1,337 | 1,306 | $42K |
| S9088 | Services provided in an urgent care center (list in addition to code for service) | 20% | 545 | 537 | $16K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 14% | 160 | 156 | $11K |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 5.9% | 34 | 33 | $5K |
| 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 | 3.3% | 45 | 44 | $3K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 3.3% | 73 | 71 | $3K |
| 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% | 17 | 17 | $770.38 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | 13 | $149.22 |
| 3078F | 0% | 430 | 424 | $0.00 | |
| 3008F | 0% | 701 | 687 | $0.00 | |
| 3074F | 0% | 378 | 375 | $0.00 | |
| 3079F | 0% | 12 | 12 | $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.