Physician

Samuel James Heiks, MD

According to 2025 Medicare claims, Samuel Heiks, MD (NPI: 1013176312) practices family practice in the Appleton, WI market, with the plurality of this provider's patient population coming from Outagamie, WI. This provider's primary affiliated billing organization is PRIMARY CARE ASSOCIATES OF APPLETON, LTD (NPI: 1659305654; TIN: 391988565) and primary practice location at 54913-6957. Heiks is affiliated with the THEDACARE ACO (ACO ID: A4988), participating under the MSSP model.

Heiks' data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 223 traditional Medicare patients, billed 3,649 HCPCS/CPT codes, and received $89,554 in Medicare payments. The top billing code was G0439 (Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit). Part D data shows 11,523 prescription claims across 789 beneficiaries totaling $911,251 in drug costs, led by Eliquis (Apixaban). DME data shows 44 claims. No Open Payments records. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has changed little. Concurrently, Part D prescription costs have moved from a lower plateau to a higher plateau, from $259,558 to $911,251. In contrast, DME billing represents a smaller volume and moved up and down with repeated peaks and valleys, starting at $633 and ending at $1,935.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	196	2,825	$64,019
2016	254	3,809	$73,119
2017	226	4,200	$78,148
2018	241	4,463	$83,750
2019	253	3,785	$76,798
2020	266	4,156	$73,943
2021	285	4,362	$89,063
2022	250	4,384	$89,423
2023	231	4,838	$104,347
2024	223	3,649	$89,554

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	451	5,410	$259,558
2016	529	7,235	$357,376
2017	531	8,289	$359,264
2018	561	8,505	$435,070
2019	647	8,870	$492,890
2020	645	9,633	$595,247
2021	682	10,049	$660,819
2022	743	10,219	$730,897
2023	787	10,715	$838,349
2024	789	11,523	$911,251

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	26	$424
2016	12	77	$2,436
2017	13	100	$1,583
2018	15	121	$2,121
2019	14	75	$1,328
2020	N/R	59	$465
2021	N/R	50	$416
2022	11	82	$3,111
2023	11	62	$1,693
2024	N/R	44	$1,230

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	144	144	$122
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	148	216	$74
80061	Blood test, lipids (cholesterol and triglycerides)	141	149	$13
36415	Insertion of needle into vein for collection of blood sample	185	473	$9
80048	Blood test, basic group of blood chemicals (calcium, total)	131	171	$8

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	193	11,820	$223,454
Ozempic	Semaglutide	115	4,592	$127,815
Trulicity	Dulaglutide	91	3,500	$116,673
Jardiance	Empagliflozin	47	3,100	$60,904
Xarelto	Rivaroxaban	18	1,630	$30,004

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	N/R	13	$810
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	N	N/R	31	$421

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for Samuel James Heiks, MD?

Tedicare shows public-source Medicare data for Samuel James Heiks, MD (NPI 1013176312), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Samuel James Heiks, MD have ACO affiliation data?

Samuel James Heiks, MD is shown with ACO affiliation data for THEDACARE ACO (MSSP, ACO ID A4988).

What billing organization is linked to Samuel James Heiks, MD?

Samuel James Heiks, MD is linked to PRIMARY CARE ASSOCIATES OF APPLETON, LTD (billing NPI 1659305654) in the available physician profile data.

Does Samuel James Heiks, MD have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.