Physician

David Andrew O'Toole, M.D.

According to 2025 Medicare claims, David O'Toole, M.D. (NPI: 1659329811) practices pain management in the Winston-Salem, NC market, with the plurality of this provider's patient population coming from Forsyth, NC. This provider's primary affiliated billing organization is NOVANT HEALTH MEDICAL GROUP, LLC (NPI: 1063134344; TIN: 581728803) and primary practice location at 27284-7198. O'Toole is affiliated with the Novant Health Accountable Care Organization I, LLC (ACO ID: A3504), participating under the MSSP model.

O'Toole's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 324 traditional Medicare patients, billed 3,798 HCPCS/CPT codes, and received $137,423 in Medicare payments. The top billing code was 64635 (Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint). Part D data shows 843 prescription claims across 348 beneficiaries totaling $28,127 in drug costs, led by Hydrocodone-Acetaminophen (Hydrocodone/Acetaminophen). 2016 DME data shows 12 claims. Open Payments data shows 36 records totaling $5,036. 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 $91,468 and ending at $137,423. Concurrently, Part D prescription costs started with an early spike, then settled into a lower baseline, moving from $361,871 to $28,127. 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	346	1,520	$91,468
2016	386	1,829	$112,240
2017	487	4,398	$131,975
2018	328	3,213	$101,777
2019	359	3,885	$173,444
2020	362	4,485	$186,564
2021	361	4,945	$198,557
2022	302	4,669	$151,759
2023	369	4,672	$179,036
2024	324	3,798	$137,423

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	371	4,514	$361,871
2016	466	4,239	$395,562
2017	745	3,815	$334,719
2018	611	2,434	$235,247
2019	352	1,091	$39,146
2020	347	887	$34,980
2021	325	858	$46,285
2022	390	1,032	$38,035
2023	432	1,145	$41,810
2024	348	843	$28,127

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	32	$1,379
2016	N/R	12	$263
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	N/R	N/R

* / # = 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
64635	Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint	65	83	$314
64483	Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level	72	90	$175
64636	Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint	57	74	$167
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	152	1,386	$1
Q9966	Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml	140	659	$0

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Hydrocodone-Acetaminophen	Hydrocodone/Acetaminophen	98	2,553	$2,412
Oxycodone-Acetaminophen	Oxycodone Hcl/Acetaminophen	77	1,668	$1,650
Gabapentin	Gabapentin	167	5,787	$1,463
Pregabalin	Pregabalin	52	1,576	$970
Tizanidine Hcl	Tizanidine Hcl	91	3,541	$948

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	34	$1,281	Boston Scientific Corporation
Research Payments	Reported research-related payment or transfer-of-value amount.	2	$3,755	Medtronic, Inc.
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 David Andrew O'Toole, M.D.?

Tedicare shows public-source Medicare data for David Andrew O'Toole, M.D. (NPI 1659329811), 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 David Andrew O'Toole, M.D. have ACO affiliation data?

David Andrew O'Toole, M.D. is shown with ACO affiliation data for Novant Health Accountable Care Organization I, LLC (MSSP, ACO ID A3504).

What billing organization is linked to David Andrew O'Toole, M.D.?

David Andrew O'Toole, M.D. is linked to NOVANT HEALTH MEDICAL GROUP, LLC (billing NPI 1063134344) in the available physician profile data.

Does David Andrew O'Toole, M.D. have Open Payments data?

David Andrew O'Toole, M.D. has 36 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.