Mcilwaine, James

Mcilwaine, James was paid $41K by Medicaid between Jan 2018 and Feb 2020, across 3 billing codes. Its largest line is 99203, doctor's office visit, new patient (routine) — 85% of everything it billed.

33Billing provider infoMCILWAINE, JAMES
WASHINGTON, MO 63090

33aNPI1558352443assigned 10/31/2005

33bProvider typeOtolaryngology Physician

28Total paid$41K

24GClaims567

24DCodes billed3

24AFirst – last monthJan 2018 – Feb 2020

Compared with peers

Next to other Otolaryngology Physician providers in Missouri

Rank by total paid#18 of 53

Median peer was paid$17K

This provider vs. median2.4×

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	288	$21K
2019	251	$18K
2020	28	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	85%	415	414	$35K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	7.5%	91	88	$3K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	7.1%	61	57	$3K

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.