Physician

Paul D Heilborn, MD

According to 2025 Medicare claims, Paul Heilborn, MD (NPI: 1841296332) practices family practice in the Jackson, MI market, with the plurality of this provider's patient population coming from Jackson, MI. This provider's primary affiliated billing organization is SPRINGCREST FAMILY PHYSICIANS, P.C. (NPI: 1134204282; TIN: 381892356) and primary practice location at 49203-2748. Heilborn is affiliated with the Mosaic ACO (ACO ID: A5033), participating under the MSSP model.

Heilborn's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 235 traditional Medicare patients, billed 1,814 HCPCS/CPT codes, and received $76,722 in Medicare payments. The top billing code was 90653 (Influenza vaccine, inactivated). Part D data shows 5,858 prescription claims across 670 beneficiaries totaling $333,305 in drug costs, led by Eliquis (Apixaban). DME data shows 62 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 moved up and down with repeated peaks and valleys, starting at $86,088 and ending at $76,722. Concurrently, Part D prescription costs have changed little. In contrast, DME billing represents a smaller volume and started with an early spike, then settled into a lower baseline, moving from $10,007 to $1,883.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	338	2,184	$86,088
2016	338	2,346	$93,552
2017	328	2,298	$90,153
2018	338	2,454	$112,597
2019	326	2,366	$113,965
2020	275	1,621	$76,848
2021	260	1,621	$91,613
2022	257	1,425	$54,366
2023	257	1,320	$49,725
2024	235	1,814	$76,722

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	451	5,405	$287,208
2016	440	5,483	$253,735
2017	463	5,638	$289,735
2018	442	5,217	$257,834
2019	435	5,248	$261,259
2020	427	4,894	$257,563
2021	374	4,462	$274,131
2022	536	5,035	$323,208
2023	660	5,907	$394,686
2024	670	5,858	$333,305

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	79	246	$5,199
2016	63	204	$2,244
2017	54	196	$2,124
2018	52	160	$1,423
2019	41	126	$2,704
2020	37	85	$714
2021	38	78	$581
2022	33	98	$1,033
2023	28	77	$572
2024	11	62	$354

* / # = 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
90653	Influenza vaccine, inactivated	57	57	$82
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	182	467	$73
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	118	185	$54
G0008	Administration of influenza virus vaccine	64	65	$30
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	178	398	$11

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	57	4,140	$74,564
Xarelto	Rivaroxaban	33	2,234	$40,867
Farxiga	Dapagliflozin Propanediol	18	1,200	$20,741
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	13	570	$11,458
Symbicort	Budesonide/Formoterol Fumarate	18	960	$7,262

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
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	N	11	21	$236
A7038	Filter, disposable, used with positive airway pressure device	N	N/R	13	$73
A7003	Administration set, with small volume nonfiltered pneumatic nebulizer, disposable	N	N/R	11	$28
A4259	Lancets, per box of 100	N	N/R	17	$17

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 Paul D. Heilborn, MD?

Tedicare shows public-source Medicare data for Paul D. Heilborn, MD (NPI 1841296332), 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 Paul D. Heilborn, MD have ACO affiliation data?

Paul D. Heilborn, MD is shown with ACO affiliation data for Mosaic ACO (MSSP, ACO ID A5033).

What billing organization is linked to Paul D. Heilborn, MD?

Paul D. Heilborn, MD is linked to SPRINGCREST FAMILY PHYSICIANS, P.C. (billing NPI 1134204282) in the available physician profile data.

Does Paul D. Heilborn, 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.