Southern WV Medical and Surgical Specialists PLLC

Southern WV Medical and Surgical Specialists PLLC was paid $108K by Medicaid between Jan 2018 and Apr 2023, across 4 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 31% of everything it billed.

33Billing provider infoSOUTHERN WV MEDICAL AND SURGICAL SPECIALISTS PLLC
LEWISBURG, WV 24901

33aNPI1497103386assigned 06/01/2016

33bProvider typeOtolaryngology Physician

28Total paid$108K

24GClaims2,061

24DCodes billed4

24AFirst – last monthJan 2018 – Apr 2023

Compared with peers

Next to other Otolaryngology Physician providers in West Virginia

Rank by total paid#7 of 11

Median peer was paid$234K

This provider vs. median0.5×

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
2018	1,120	$67K
2019	382	$15K
2020	261	$12K
2021	161	$6K
2022	64	$5K
2023	73	$4K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	31%	360	305	$34K
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	31%	727	660	$33K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	28%	792	706	$30K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	9.9%	182	159	$11K

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 officialDOUGLAS, JUSTIN (OWNER/PRESIDENT)