Sumida, Michael

Sumida, Michael was paid $3K by Medicaid between Aug 2018 and Mar 2021, across 2 billing codes. Its largest line is 99203, doctor's office visit, new patient (routine) — 67% of everything it billed.

33Billing provider infoSUMIDA, MICHAEL
ATHENS, TN 37303

33aNPI1609835115assigned 03/22/2006

33bProvider typeSurgery Physician

28Total paid$3K

24GClaims86

24DCodes billed2

24AFirst – last monthAug 2018 – Mar 2021

Compared with peers

Next to other Surgery Physician providers in Tennessee

Rank by total paid#62 of 87

Median peer was paid$9K

This provider vs. median0.3×

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	40	$1K
2019	34	$852.96
2021	12	$554.70

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	67%	43	38	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	33%	43	38	$843.81

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.