Schmelkin, Ira

Schmelkin, Ira was paid $60K by Medicaid between Jun 2018 and Dec 2022, across 3 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 60% of everything it billed.

33Billing provider infoSCHMELKIN, IRA
WESTFIELD, MA 01085

33aNPI1699746602assigned 01/28/2006

33bProvider typeGastroenterology Physician

28Total paid$60K

24GClaims626

24DCodes billed3

24AFirst – last monthJun 2018 – Dec 2022

Compared with peers

Next to other Gastroenterology Physician providers in Massachusetts

Rank by total paid#20 of 71

Median peer was paid$11K

This provider vs. median5.4×

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	35	$4K
2019	13	$2K
2020	13	$2K
2021	293	$27K
2022	272	$26K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	60%	314	314	$36K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	23%	177	177	$14K
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	17%	135	135	$10K

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.