Roache, Edmund

Roache, Edmund was paid $115K by Medicaid between Jan 2018 and Oct 2024, across 7 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 51% of everything it billed.

33Billing provider infoROACHE, EDMUND
WATERTOWN, NY 13601

33aNPI1780636704assigned 05/17/2006

33bProvider typeInternal Medicine Physician

28Total paid$115K

24GClaims3,863

24DCodes billed7

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Internal Medicine Physician providers in New York

Rank by total paid#1,178 of 6,049

Median peer was paid$11K

This provider vs. median10×

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	852	$20K
2019	1,000	$24K
2020	476	$11K
2021	594	$10K
2022	288	$12K
2023	407	$23K
2024incomplete	246	$15K

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	51%	1,752	1,676	$59K
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	44%	990	942	$50K
99051		3.5%	894	862	$4K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	1.6%	45	45	$2K
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	<1%	128	128	$33.64
99000		<1%	13	13	$2.47
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	0%	41	40	$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.