University of Penn - Medical Group
University of Penn - Medical Group was paid $1.13M by Medicaid between Jan 2018 and Nov 2024, across 17 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 67% of everything it billed.
PHILADELPHIA, PA 19104
Next to other Internal Medicine Physician providers in Pennsylvania
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 154 | $281.55 | |
| 2020 | 860 | $50K | |
| 2021 | 6,321 | $323K | |
| 2022 | 6,119 | $256K | |
| 2023 | 6,206 | $265K | |
| 2024incomplete | 5,342 | $233K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 67% | 4,993 | 1,889 | $751K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 8.6% | 1,412 | 1,344 | $97K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 7.8% | 1,388 | 534 | $88K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 5.0% | 1,040 | 1,001 | $56K |
| 94010 | 3.2% | 6,484 | 6,200 | $36K | |
| 94726 | 3.1% | 3,700 | 3,596 | $35K | |
| 94729 | 2.6% | 4,401 | 4,273 | $29K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.3% | 301 | 297 | $14K |
| 94618 | <1% | 428 | 414 | $7K | |
| 99205 | Prolong outpt/office vis | <1% | 27 | 27 | $4K |
| 94060 | <1% | 371 | 367 | $3K | |
| 99292 | <1% | 20 | 12 | $1K |
5 more codes
| 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 single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 157 | $1K |
| 90686 | <1% | 221 | $1K | |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | <1% | 26 | $725.38 |
| 99451 | <1% | 21 | $336.28 | |
| 93000 | <1% | 12 | $225.07 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.