Physician

Michael E Jones, M.D.

According to 2025 Medicare claims, Michael Jones, M.D. (NPI: 1083611636) practices gastroenterology in the Cincinnati, OH-KY-IN market, with the plurality of this provider's patient population coming from Boone, KY. This provider's primary affiliated billing organization is TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC (NPI: 1306843842; TIN: 611192347) and primary practice location at 41017-3409. Jones is affiliated with the Healthcare Solutions Network (ACO ID: A3283), participating under the MSSP model.

Jones' data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 414 traditional Medicare patients, billed 11,764 HCPCS/CPT codes, and received $198,852 in Medicare payments. The top billing code was 45380 (Biopsy of large bowel using a flexible endoscope). Part D data shows 2,447 prescription claims across 715 beneficiaries totaling $601,680 in drug costs, led by Linzess (Linaclotide). DME data shows 50 claims. Open Payments data shows 245 records totaling $450,061. 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 did not follow a clear longitudinal pattern. Concurrently, Part D prescription costs started with an early spike, then settled into a lower baseline, moving from $966,468 to $601,680. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	504	2,249	$137,623
2016	502	1,623	$110,037
2017	502	1,156	$101,393
2018	488	2,651	$99,703
2019	444	2,561	$92,985
2020	426	1,012	$85,182
2021	420	7,837	$89,031
2022	426	8,950	$117,197
2023	427	14,584	$156,333
2024	414	11,764	$198,852

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	408	2,918	$966,468
2016	446	2,897	$366,674
2017	453	2,614	$346,981
2018	487	2,332	$595,664
2019	544	2,544	$372,438
2020	516	2,203	$361,542
2021	584	2,451	$300,936
2022	641	2,607	$262,140
2023	657	2,434	$194,496
2024	715	2,447	$601,680

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	11	$122
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	N/R	N/R	N/R
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	N/R	N/R
2024	N/R	50	$1,988

* / # = 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
45380	Biopsy of large bowel using a flexible endoscope	200	203	$128
43248	Insertion of guide wire with dilation of esophagus using a flexible endoscope	72	75	$92
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	118	154	$84
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	71	81	$62
43239	Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	133	142	$32

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Linzess	Linaclotide	65	2,670	$46,908
Sod Sulf-Potass Sulf-Mag Sulf	Sodium, Potassium,mag Sulfates	310	1,100	$19,752
Misoprostol	Misoprostol	136	5,520	$10,232
Omeprazole	Omeprazole	802	51,471	$9,501
Dexilant	Dexlansoprazole	18	900	$8,978

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
A4407	Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each	N	N/R	13	$1,041
A4385	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each	N	N/R	13	$436
A4425	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each	N	N/R	13	$306
A4436	Irrigation supply; sleeve, reusable, per month	N	N/R	11	$205

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	9	$310	ABBVIE INC.
Research Payments	Reported research-related payment or transfer-of-value amount.	236	$449,751	Janssen Research & Development, LLC
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

Explore More Providers

FAQ

What Medicare data is available for Michael E. Jones, M.D.?

Tedicare shows public-source Medicare data for Michael E. Jones, M.D. (NPI 1083611636), 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 Michael E. Jones, M.D. have ACO affiliation data?

Michael E. Jones, M.D. is shown with ACO affiliation data for Healthcare Solutions Network (MSSP, ACO ID A3283).

What billing organization is linked to Michael E. Jones, M.D.?

Michael E. Jones, M.D. is linked to TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC (billing NPI 1306843842) in the available physician profile data.

Does Michael E. Jones, M.D. have Open Payments data?

Michael E. Jones, M.D. has 245 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.