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    OpenPayerNPI Medicare & MedicaidJames Hoover
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    James Hoover — Billing Profile & Reimbursement Data

    NPI 1346243391 · Troy, OH · Physical Medicine & Rehabilitation Physician

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    James Hoover is a physical medicine & rehabilitation physician provider located in Troy, Ohio. This profile covers 10 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Hoover
    Address998 S Dorset Rd
    CityTroy
    StateOH
    ZIP45373
    TaxonomyPhysical Medicine & Rehabilitation Physician
    NPI EnumeratedMay 23, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$85.6K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    95886The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…370$70$26.5K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…390$60$24K
    95909In this procedure, the provider performs five or six nerve conduction studies, a diagnostic test to evaluate the function, especially the ability of electrical conduction of the motor and sensory…120$90$10.6K
    95911In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…70$140$9.2K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…60$100$6K
    99238The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…50$60$3.1K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…30$70$2.3K
    95908In this procedure, the provider performs three or four nerve conduction studies, a diagnostic test to evaluate the function, especially the ability of electrical conduction of the motor and sensory…30$80$2.2K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…20$60$1.3K
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…10$60$620

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    10 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992326518,05070$60$8.7K
    958861326090$60$6.9K
    9921316,94720,00070$50$6.6K
    959111514020$140$4.9K
    992221,0855,48030$100$4.2K
    992032,7706,38030$60$2.9K
    95909315030$80$2.6K
    992382521,18020$60$2.3K
    95908155020$70$1.9K
    9920277885020$40$1.2K

    Nearby Providers

    Other providers in the same ZIP code as James Hoover, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Upper Valley Medical CenterOHGeneral Acute Care Hospital$0$18.3M
    Hospice Of Miami County, Inc.OHCommunity Based Hospice Care Agency$0$11.3M
    Kettering Medical CenterOHGeneral Acute Care Hospital$0$10.8M
    Hometown Urgent Care Of Michigan, P.C.OHClinical Medical Laboratory$14.4K$3.8M
    Rajeev KulkarniOHHematology & Oncology Physician$1.7M$0
    City Of Troy-city AuditorOHLand Ambulance$311.7K$951.5K
    Ronald SetzkornOHRadiation Oncology Physician$590.8K$0
    Scott SwabbOHInternal Medicine Physician$355.5K$0
    James RademacherOHOphthalmology Physician$313.1K$0
    Georges YacoubOHCritical Care Medicine (Internal Medicine) Physician$258.7K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Ohio Distribution
    James Hoover — 2 of 10 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Ohio