Physician

James Ralph Heltsley, D.O.

According to 2025 Medicare claims, James Heltsley, D.O. (NPI: 1881998490) practices orthopedic surgery in the Bowling Green, KY market, with the plurality of this provider's patient population coming from Warren, KY. This provider's primary affiliated billing organization is GRAVES GILBERT CLINIC PLLC (NPI: 1114948288; TIN: 610700826) and primary practice location at 42103-7940. Heltsley is affiliated with the Caravan Collaborative Pathways (ACO ID: A4604), Caravan Health ACO 50 LLC (ACO ID: A5160), and GGC ValueCare LLC (ACO ID: A5611), participating under the MSSP model.

Heltsley's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 598 traditional Medicare patients, billed 15,680 HCPCS/CPT codes, and received $288,903 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 1,190 prescription claims across 483 beneficiaries totaling $12,699 in drug costs, led by Diclofenac Sodium (Diclofenac Sodium). DME data shows 17 claims. Open Payments data shows 6 records totaling $471. 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 risen steadily, from $55,068 to $288,903. Concurrently, Part D prescription costs did not follow a clear longitudinal pattern. For DME billing, reported payments moved up and down with repeated peaks and valleys, starting at $18,968 and ending at $8,542.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	181	644	$55,068
2017	546	2,732	$208,317
2018	559	3,173	$235,266
2019	600	3,649	$248,570
2020	490	3,040	$218,142
2021	637	7,155	$346,775
2022	637	7,404	$285,419
2023	665	14,440	$310,011
2024	598	15,680	$288,903

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	49	73	$1,745
2016	151	272	$6,808
2017	313	645	$14,326
2018	348	776	$12,439
2019	419	897	$16,318
2020	356	872	$11,677
2021	450	1,043	$13,224
2022	398	945	$11,279
2023	450	1,008	$12,608
2024	483	1,190	$12,699

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	80	80	$6,358
2018	95	97	$9,527
2019	87	101	$9,021
2020	28	40	$3,800
2021	77	97	$6,695
2022	33	33	$3,275
2023	81	81	$7,113
2024	17	17	$1,768

* / # = 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	216	285	$90
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	249	341	$65
20610	Aspiration and/or injection of fluid from large joint	301	547	$50
96372	Injection of drug or substance under skin or into muscle	112	132	$10
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	380	6,104	$1

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Diclofenac Sodium	Diclofenac Sodium	394	14,151	$4,294
Celecoxib	Celecoxib	79	2,755	$2,805
Oxycodone-Acetaminophen	Oxycodone Hcl/Acetaminophen	229	1,970	$2,417
Methylprednisolone	Methylprednisolone	129	775	$698
Hydrocodone-Acetaminophen	Hydrocodone/Acetaminophen	66	464	$433

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
L1820	Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	N	17	17	$1,768

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	6	$471	Music City Medical Technologies, LLC
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 Ralph Heltsley, D.O.?

Tedicare shows public-source Medicare data for James Ralph Heltsley, D.O. (NPI 1881998490), 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 Ralph Heltsley, D.O. have ACO affiliation data?

James Ralph Heltsley, D.O. is shown with ACO affiliation data for Caravan Collaborative Pathways (MSSP, ACO ID A4604), Caravan Health ACO 50 LLC (MSSP, ACO ID A5160), and GGC ValueCare LLC (MSSP, ACO ID A5611).

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

James Ralph Heltsley, D.O. is linked to GRAVES GILBERT CLINIC PLLC (billing NPI 1114948288) in the available physician profile data.

Does James Ralph Heltsley, D.O. have Open Payments data?

James Ralph Heltsley, D.O. has 6 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.