Fernandez, James

Fernandez, James was paid $174K by Medicaid between Jan 2018 and Dec 2024, across 15 billing codes. Its largest line is 99202, Office or other outpatient visit for the evaluation and management of a new patient, straightforward — 25% of everything it billed.

33Billing provider infoFERNANDEZ, JAMES
GRANITE CITY, IL 62040

33aNPI1528037280assigned 03/15/2006

33bProvider typeOtolaryngology Physician

28Total paid$174K

24GClaims5,290

24DCodes billed15

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Otolaryngology Physician providers in Illinois

Rank by total paid#33 of 221

Median peer was paid$21K

This provider vs. median8.4×

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	1,052	$37K
2019	574	$16K
2020	466	$12K
2021	1,516	$54K
2022	850	$27K
2023	498	$16K
2024incomplete	334	$13K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	25%	1,453	1,381	$44K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	25%	1,019	936	$43K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	20%	1,567	1,450	$35K
0001A		7.7%	320	312	$13K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	6.9%	290	283	$12K
0002A		6.4%	268	265	$11K
0012A		2.5%	104	104	$4K
69436	Tympanostomy (requiring insertion of ventilating tube), general anesthesia	1.7%	30	24	$3K
0011A		1.6%	65	65	$3K
99201		1.2%	79	79	$2K
0004A		<1%	36	36	$1K
0064A		<1%	18	18	$756.38

3 more codes

0072A		<1%	13	$520.00
0071A		<1%	13	$520.00
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	15	$154.56

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.