J. Darvin Hales, DO, FCCP, Apmc

J. Darvin Hales, DO, FCCP, Apmc was paid $21K by Medicaid between Jan 2018 and Jul 2018, across 7 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 54% of everything it billed.

33Billing provider infoJ. DARVIN HALES, DO, FCCP, APMC
NEW IBERIA, LA 70560

33aNPI1689739559assigned 12/22/2006

33bProvider typeSleep Medicine (Internal Medicine) Physician

28Total paid$21K

24GClaims1,495

24DCodes billed7

24AFirst – last monthJan 2018 – Jul 2018

Compared with peers

Next to other Sleep Medicine (Internal Medicine) Physician providers in Louisiana

Rank by total paid#4 of 6

Median peer was paid$21K

This provider vs. median1.0×

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	1,495	$21K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	54%	546	496	$12K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	18%	51	51	$4K
95811		12%	19	16	$3K
95810	Polysomnography; sleep staging with 4 or more additional parameters	7.8%	12	12	$2K
94010		5.8%	118	110	$1K
94060		1.9%	14	14	$407.09
94760		<1%	735	557	$135.03

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 officialHALES, JAMES (OWNER)