Physician
Simons, Stephan
Simons, Stephan was paid $77K by Medicaid between Jan 2018 and Dec 2023, across 19 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 76% of everything it billed.
33Billing provider infoSIMONS, STEPHAN
BRONX, NY 10472
BRONX, NY 10472
33aNPI1710928304assigned 06/08/2006
33bProvider typeInternal Medicine Physician
28Total paid$77K
24GClaims4,868
24DCodes billed19
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other Internal Medicine Physician providers in New York
Rank by total paid#1,420 of 6,049
Median peer was paid$11K
This provider vs. median6.8×
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 | 475 | $14K | |
| 2019 | 414 | $14K | |
| 2020 | 2,516 | $18K | |
| 2021 | 1,030 | $11K | |
| 2022 | 192 | $10K | |
| 2023 | 241 | $11K |
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 | 76% | 1,405 | 1,338 | $58K |
| 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 | 16% | 191 | 187 | $13K |
| 99442 | 3.1% | 102 | 100 | $2K | |
| 99443 | 2.5% | 47 | 46 | $2K | |
| 99441 | 1.9% | 81 | 81 | $1K | |
| H0049 | Alcohol and/or drug screening | <1% | 232 | 223 | $203.27 |
| H0001 | Alcohol and/or drug assessment | 0% | 98 | 94 | $0.00 |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 80 | 78 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 144 | 140 | $0.00 |
| 1000F | 0% | 195 | 185 | $0.00 | |
| 1036F | 0% | 63 | 62 | $0.00 | |
| 3008F | 0% | 134 | 103 | $0.00 |
7 more codes
| 3074F | 0% | 12 | $0.00 | |
| 3016F | 0% | 216 | $0.00 | |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | 0% | 217 | $0.00 |
| 99080 | 0% | 1,428 | $0.00 | |
| G9507 | Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs) | 0% | 42 | $0.00 |
| 3725F | 0% | 140 | $0.00 | |
| 0521F | 0% | 41 | $0.00 |
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.