Sims, Michael

Sims, Michael was paid $97K by Medicaid between Jan 2018 and Aug 2021, across 4 billing codes. Its largest line is 99285, emergency room visit (most serious) — 39% of everything it billed.

33Billing provider infoSIMS, MICHAEL
ELGIN, IL 60120

33aNPI1538108238assigned 06/06/2006

33bProvider typeEmergency Medicine Physician

28Total paid$97K

24GClaims2,413

24DCodes billed4

24AFirst – last monthJan 2018 – Aug 2021

Compared with peers

Next to other Emergency Medicine Physician providers in Illinois

Rank by total paid#1,236 of 1,980

Median peer was paid$150K

This provider vs. median0.6×

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	809	$29K
2019	1,008	$38K
2020	583	$29K
2021	13	$478.32

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	39%	639	578	$37K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	33%	853	792	$32K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	26%	823	747	$25K
99282	Emergency department visit for the evaluation and management, low to moderate severity	2.2%	98	92	$2K

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.