Clinic
John C Simmons M.D.
John C Simmons M.D. was paid $395K by Medicaid between Jan 2018 and Nov 2024, across 42 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 63% of everything it billed.
33Billing provider infoJOHN C SIMMONS M.D.
LINDEN, AL 36748
LINDEN, AL 36748
33aNPI1851614721assigned 03/08/2010
33bProvider typePrimary Care Clinic/Center
28Total paid$395K
24GClaims21,545
24DCodes billed42
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Alabama
Rank by total paid#21 of 75
Median peer was paid$56K
This provider vs. median7.0×
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 | 5,732 | $40K | |
| 2019 | 4,298 | $53K | |
| 2020 | 2,501 | $67K | |
| 2021 | 2,725 | $69K | |
| 2022 | 2,874 | $68K | |
| 2023 | 2,127 | $55K | |
| 2024incomplete | 1,288 | $42K |
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 | 63% | 5,239 | 4,649 | $247K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 30% | 3,342 | 2,896 | $119K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.5% | 1,881 | 1,649 | $10K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 1.4% | 1,338 | 1,226 | $5K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.4% | 286 | 262 | $5K |
| 99490 | Ccm add 20min | <1% | 1,293 | 1,246 | $2K |
| 81002 | <1% | 1,413 | 1,294 | $2K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 110 | 54 | $1K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 291 | 272 | $793.74 |
| 80305 | <1% | 155 | 143 | $785.25 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 148 | 141 | $528.00 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 371 | 344 | $339.41 |
30 more codes
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 104 | $302.34 |
| 0031A | <1% | 15 | $240.00 | |
| 87400 | <1% | 64 | $210.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 872 | $202.86 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 78 | $103.24 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 12 | $77.84 |
| 99457 | <1% | 321 | $68.40 | |
| 99000 | <1% | 14 | $49.00 | |
| 99454 | <1% | 250 | $45.16 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 31 | $28.00 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 17 | $25.98 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 823 | $0.00 |
| 1100F | 0% | 32 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 713 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 1,109 | $0.00 |
| 0518F | 0% | 192 | $0.00 | |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 0% | 29 | $0.00 |
| 99307 | 0% | 22 | $0.00 | |
| 99080 | 0% | 38 | $0.00 | |
| 3078F | 0% | 15 | $0.00 | |
| 4004F | 0% | 13 | $0.00 | |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 14 | $0.00 |
| 3077F | 0% | 22 | $0.00 | |
| 1101F | 0% | 584 | $0.00 | |
| G8866 | Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal) | 0% | 215 | $0.00 |
| 3074F | 0% | 17 | $0.00 | |
| 3080F | 0% | 15 | $0.00 | |
| 3079F | 0% | 19 | $0.00 | |
| 96127 | 0% | 12 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 16 | $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 officialSIMMONS, JOHN (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| John F. Simmons M.D. P.C | Geneva, AL | $831K |
| Vinton County Local Schools | Mc Arthur, OH | $489K |
| New Mexico Brain Institute, INC. | Alamogordo, NM | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.