PHILLIP G MAIDEN, M.D.
NPI 1063418168, individual, Warren, OH, Psychiatry & Neurology, Psychiatry
- Medicaid dollars per patient on code 99213 ($167 per patient-month) sit in the top 5% of every provider billing that code.
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PHILLIP G MAIDEN, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | June 23, 2005, last updated January 14, 2009 |
| Practice location | 1704 NORTH RD SE, Warren, OH 44484-2958, 330-758-4515 |
| Mailing address | PO BOX 5384, Youngstown, OH 44514-0384 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 35063252M OH) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H2020 | Therapeutic behavioral services per diem | $3.8M | 49% | $1K | $455 (top 5% from $2K) | 89th percentile | |
| H2012 | Behavioral health day treatment per hour | $1.6M | 20% | $577 | $677 (top 5% from $3K) | 46th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.0M | 13% | $167 | $44 (top 5% from $110) | 98th percentile | |
| 90832 | Psychotherapy, 30 minutes | $439K | 6% | $179 | $59 (top 5% from $239) | 92nd percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $312K | 4% | $159 | $60 (top 5% from $133) | 97th percentile | |
| 90834 | Psychotherapy, 45 minutes | $171K | 2% | $132 | $101 (top 5% from $318) | 66th percentile | |
| H0036 | Community psychiatric supportive treatment face-to-face per 15 minhistory of abuse | $171K | 2% | $124 | $195 (top 5% from $1K) | 38th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $140K | 2% | $166 | $191 (top 5% from $442) | 38th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 82 | 23 | $5K | $100 | $86 | 1.2x | 2.2x (90th percentile 3.8x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
3 providers in Trumbull County, OH carry an indicator in the public record, with $23K at stake between them. The most common is part of a provider network, on 2 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | NILES SKILLED NURSING, LLC Niles, OH, ranked 4878 | $0 |
|
| 3 | MINERAL RIDGE SKILLED NURSING AND RESIDENTIAL CARE, LLC Mineral Ridge, OH, ranked 7162 | $0 |
|
| 4 | JOHN KELLY Newton Falls, OH, ranked 9700 | $23K |
|
Recent enforcement in OH
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.