Physician
James R. Toothman DO PLLC
James R. Toothman DO PLLC was paid $103K by Medicaid between Jun 2019 and Oct 2024, across 8 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 81% of everything it billed.
33Billing provider infoJAMES R. TOOTHMAN DO PLLC
GALLIPOLIS, OH 45631
GALLIPOLIS, OH 45631
33aNPI1528627957assigned 06/10/2019
33bProvider typeInternal Medicine Physician
28Total paid$103K
24GClaims11,817
24DCodes billed8
24AFirst – last monthJun 2019 – Oct 2024
Compared with peers
Next to other Internal Medicine Physician providers in Ohio
Rank by total paid#196 of 663
Median peer was paid$17K
This provider vs. median5.9×
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 | |
|---|---|---|---|
| 2019 | 1,504 | $4K | |
| 2020 | 2,799 | $10K | |
| 2021 | 2,960 | $15K | |
| 2022 | 2,860 | $35K | |
| 2023 | 756 | $25K | |
| 2024incomplete | 938 | $14K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 81% | 9,270 | 6,877 | $84K |
| 99336 | 7.6% | 979 | 934 | $8K | |
| 99305 | 4.0% | 273 | 251 | $4K | |
| 99349 | 3.7% | 80 | 72 | $4K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | 1.5% | 892 | 681 | $1K |
| 99318 | <1% | 201 | 201 | $944.14 | |
| 99497 | <1% | 52 | 52 | $767.04 | |
| 99307 | <1% | 70 | 47 | $271.65 |
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 officialCARDENAS, ALLY (AUTHORIZED OFFICIAL/CREDENTIALING S)