Physician
John E Balmer JR. DO
John E Balmer JR. DO was paid $379K by Medicaid between Jan 2018 and Nov 2024, across 6 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.
33Billing provider infoJOHN E BALMER JR. DO
SPARTANSBURG, PA 16434
SPARTANSBURG, PA 16434
33aNPI1639238900assigned 12/06/2006
33bProvider typeFamily Medicine Physician
28Total paid$379K
24GClaims8,280
24DCodes billed6
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Family Medicine Physician providers in Pennsylvania
Rank by total paid#190 of 2,756
Median peer was paid$19K
This provider vs. median20×
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 | 906 | $27K | |
| 2019 | 1,086 | $38K | |
| 2020 | 525 | $25K | |
| 2021 | 1,330 | $78K | |
| 2022 | 1,606 | $84K | |
| 2023 | 1,667 | $68K | |
| 2024incomplete | 1,160 | $58K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 99% | 5,313 | 4,278 | $375K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 1,616 | 1,430 | $3K |
| 3078F | <1% | 585 | 539 | $515.00 | |
| 3074F | <1% | 479 | 440 | $315.00 | |
| 3079F | <1% | 87 | 80 | $75.00 | |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | <1% | 200 | 185 | $54.42 |
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 officialBALMER, PATRICIA (OFFICE MANAGER)
| Provider | Location | Paid |
|---|---|---|
| John E Balmer JR., DO | Union City, PA | $46K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.