Physician

James Simmons, D.O.

According to 2025 Medicare claims, James Simmons, D.O. (NPI: 1043519853) practices hospitalist in the Hanford-Corcoran, CA market, with the plurality of this provider's patient population coming from Kings, CA. This provider's primary affiliated billing organization is GALEN INPATIENT PHYSICIANS INC (NPI: 1114285657; TIN: 943342387) and primary practice location at 93230-5786. Simmons is affiliated with the Adventist Health Accountable Care, LLC (ACO ID: A3873), participating under the MSSP model.

Simmons' data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 396 traditional Medicare patients, billed 957 HCPCS/CPT codes, and received $89,321 in Medicare payments. The top billing code was 99223 (Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes). Part D data shows 360 prescription claims across 158 beneficiaries totaling $15,598 in drug costs, led by Eliquis (Apixaban). DME data shows 66 claims. Open Payments data shows 3 records totaling $309. 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 moved up and down with repeated peaks and valleys, starting at $62,787 and ending at $89,321. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $4,330 and ending at $15,598. In contrast, DME billing represents a smaller volume and rose steadily, from $603 to $3,818.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	313	788	$62,787
2016	516	1,373	$110,010
2017	586	1,445	$120,311
2018	475	1,192	$94,980
2019	490	1,173	$97,585
2020	383	994	$80,733
2021	382	825	$66,420
2022	367	943	$77,905
2023	380	1,059	$102,501
2024	396	957	$89,321

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	50	96	$4,330
2016	142	356	$20,866
2017	178	842	$29,508
2018	241	3,525	$88,469
2019	249	1,798	$57,305
2020	199	1,057	$35,751
2021	139	346	$16,360
2022	116	261	$17,826
2023	170	367	$88,065
2024	158	360	$15,598

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	35	$820
2018	N/R	59	$1,551
2019	N/R	64	$1,736
2020	N/R	114	$3,720
2021	25	150	$6,670
2022	N/R	140	$5,734
2023	12	117	$5,016
2024	N/R	66	$3,344

* / # = 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
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	153	162	$132
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	219	484	$92
99239	Hospital discharge day management, more than 30 minutes	127	127	$90
99238	Hospital discharge day management, 30 minutes or less	13	13	$64
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	106	150	$62

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	13	356	$7,029
Escitalopram Oxalate	Escitalopram Oxalate	26	728	$357
Levothyroxine Sodium	Levothyroxine Sodium	14	394	$124
Tamsulosin Hcl	Tamsulosin Hcl	16	424	$91
Hydrocodone-Acetaminophen	Hydrocodone/Acetaminophen	12	60	$71

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	32	$2,218
E0260	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	Y	N/R	12	$770
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	Y	N/R	22	$357

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	3	$309	Janssen Pharmaceuticals, Inc
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for James Simmons, D.O.?

Tedicare shows public-source Medicare data for James Simmons, D.O. (NPI 1043519853), 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 James Simmons, D.O. have ACO affiliation data?

James Simmons, D.O. is shown with ACO affiliation data for Adventist Health Accountable Care, LLC (MSSP, ACO ID A3873).

What billing organization is linked to James Simmons, D.O.?

James Simmons, D.O. is linked to GALEN INPATIENT PHYSICIANS INC (billing NPI 1114285657) in the available physician profile data.

Does James Simmons, D.O. have Open Payments data?

James Simmons, D.O. has 3 connected Open Payments records in the available 2024 summary 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.