Physician
Royal Oak Medical Associates PC
Royal Oak Medical Associates PC was paid $604K by Medicaid between Jan 2018 and Mar 2024, across 30 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 61% of everything it billed.
33Billing provider infoROYAL OAK MEDICAL ASSOCIATES PC
MARION, VA 24354
MARION, VA 24354
33aNPI1720035959assigned 05/31/2006
33bProvider typeFamily Medicine Physician
28Total paid$604K
24GClaims36,968
24DCodes billed30
24AFirst – last monthJan 2018 – Mar 2024
Compared with peers
Next to other Family Medicine Physician providers in Virginia
Rank by total paid#59 of 772
Median peer was paid$13K
This provider vs. median46×
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 | 1,016 | $10K | |
| 2019 | 2,860 | $67K | |
| 2020 | 5,772 | $102K | |
| 2021 | 7,004 | $105K | |
| 2022 | 8,329 | $132K | |
| 2023 | 9,691 | $151K | |
| 2024incomplete | 2,296 | $38K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 61% | 6,247 | 5,428 | $366K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 32% | 4,253 | 3,654 | $192K |
| 3074F | 1.3% | 4,779 | 4,202 | $8K | |
| 3078F | 1.1% | 3,843 | 3,391 | $7K | |
| 3079F | <1% | 2,751 | 2,453 | $5K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,701 | 2,363 | $4K |
| 90686 | <1% | 269 | 240 | $3K | |
| 80061 | Lipid panel | <1% | 387 | 342 | $3K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 116 | 96 | $3K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 348 | 308 | $2K |
| 90756 | <1% | 110 | 89 | $2K | |
| 87428 | <1% | 60 | 55 | $2K |
18 more codes
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 321 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 114 | $1K |
| 90688 | <1% | 103 | $1K | |
| 3075F | <1% | 379 | $950.00 | |
| 3077F | <1% | 395 | $950.00 | |
| 99490 | Ccm add 20min | <1% | 92 | $652.46 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 18 | $511.94 |
| 81001 | <1% | 122 | $260.11 | |
| 99422 | <1% | 15 | $244.25 | |
| 3080F | <1% | 104 | $225.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 15 | $161.40 |
| 99421 | <1% | 15 | $159.97 | |
| G0008 | Administration of influenza virus vaccine | <1% | 15 | $68.40 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | <1% | 8,582 | $0.03 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 452 | $0.00 |
| G2181 | Bmi not documented due to medical reason or patient refusal of height or weight measurement | 0% | 301 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 48 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 13 | $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.
From NPPES
Who's on the registration
Authorized officialMCDOWELL, JAMES (OFFICER)
Parent organizationROYAL OAK MEDICAL ASSOCIATES
| Provider | Location | Paid |
|---|---|---|
| Safe Havens Home Health LLC | Charlotte, NC | $1.22M |
| DRS Kelley & Mcdowell PA | Kershaw, SC | $122K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.