Physician

James P Twesten-Otoole, MD

According to 2025 Medicare claims, James Twesten-Otoole, MD (NPI: 1174599344) practices addiction medicine in the Muskegon-Norton Shores, MI market, with the plurality of this provider's patient population coming from Muskegon, MI. This provider's primary affiliated billing organization is MERCY PHYSICIAN NETWORK (NPI: 1023056744; TIN: 383589210) and primary practice location at 49441-4576. Twesten-Otoole is affiliated with the Trinity Health Integrated Care (ACO ID: A3454), participating under the MSSP model.

Twesten-Otoole's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 14 traditional Medicare patients, billed 145 HCPCS/CPT codes, and received $7,330 in Medicare payments. The top billing code was 99214 (Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more). Part D data shows 983 prescription claims across 247 beneficiaries totaling $141,425 in drug costs, led by Buprenorphine-Naloxone (Buprenorphine Hcl/Naloxone Hcl). DME data shows 48 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 fallen sharply in recent years, from $28,353 to $7,330. Similarly, Part D prescription costs have fallen sharply in recent years, from $736,123 to $141,425. For DME billing, reported payments moved up and down with repeated peaks and valleys, starting at $32,569 and ending at $27,488.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	210	587	$28,353
2016	232	605	$27,502
2017	217	597	$27,432
2018	212	575	$27,388
2019	211	576	$25,800
2020	152	309	$13,739
2021	149	309	$17,877
2022	130	271	$16,057
2023	83	156	$9,010
2024	14	145	$7,330

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	520	11,155	$736,123
2016	490	10,818	$745,466
2017	488	11,074	$871,251
2018	482	10,507	$887,379
2019	540	9,880	$872,222
2020	550	9,221	$931,963
2021	590	9,184	$966,970
2022	607	8,842	$949,596
2023	583	7,505	$984,789
2024	247	983	$141,425

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	77	533	$31,946
2016	89	420	$19,688
2017	44	294	$7,408
2018	34	232	$9,853
2019	18	167	$3,610
2020	19	187	$14,913
2021	16	171	$17,170
2022	N/R	112	$12,407
2023	N/R	144	$34,151
2024	N/R	48	$25,398

* / # = 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
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	41	$67
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	11	53	$13

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Buprenorphine-Naloxone	Buprenorphine Hcl/Naloxone Hcl	196	4,196	$34,916
Zubsolv	Buprenorphine Hcl/Naloxone Hcl	15	379	$9,218
Suboxone	Buprenorphine Hcl/Naloxone Hcl	13	362	$6,530
Acamprosate Calcium	Acamprosate Calcium	29	739	$2,761
Naltrexone Hcl	Naltrexone Hcl	73	2,471	$2,672

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
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	Y	N/R	24	$24,318
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	N/R	12	$883
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	Y	N/R	12	$197

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 James P. Twesten-Otoole, MD?

Tedicare shows public-source Medicare data for James P. Twesten-Otoole, MD (NPI 1174599344), 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 P. Twesten-Otoole, MD have ACO affiliation data?

James P. Twesten-Otoole, MD is shown with ACO affiliation data for Trinity Health Integrated Care (MSSP, ACO ID A3454).

What billing organization is linked to James P. Twesten-Otoole, MD?

James P. Twesten-Otoole, MD is linked to MERCY PHYSICIAN NETWORK (billing NPI 1023056744) in the available physician profile data.

Does James P. Twesten-Otoole, 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.