Physician
Wellspan Medical Group
Wellspan Medical Group was paid $9.90M by Medicaid between Jan 2018 and Dec 2024, across 68 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 29% of everything it billed.
33Billing provider infoWELLSPAN MEDICAL GROUP
YORK, PA 17403
YORK, PA 17403
33aNPI1073064796assigned 10/18/2016
33bProvider typePediatrics Physician
28Total paid$9.90M
24GClaims237,437
24DCodes billed68
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#5 of 1,257
Median peer was paid$45K
This provider vs. median218×
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.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 5,531 | $334K | |
| 2019 | 6,070 | $368K | |
| 2020 | 12,067 | $529K | |
| 2021 | 57,153 | $2.58M | |
| 2022 | 56,152 | $2.24M | |
| 2023 | 50,876 | $1.95M | |
| 2024incomplete | 49,588 | $1.89M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 29% | 60,594 | 57,308 | $2.83M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 17% | 17,553 | 17,100 | $1.73M |
| 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 | 17% | 23,319 | 22,172 | $1.68M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 16% | 17,185 | 16,778 | $1.56M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.7% | 10,098 | 9,640 | $957K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.3% | 3,266 | 3,061 | $325K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.4% | 10,370 | 9,881 | $138K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 1,988 | 1,964 | $77K |
| 90686 | <1% | 10,982 | 10,753 | $61K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 3,499 | 3,282 | $55K |
| 90734 | <1% | 1,385 | 1,324 | $50K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,332 | 1,282 | $44K |
56 more codes
| 90670 | <1% | 6,638 | $43K | |
| 90698 | <1% | 9,275 | $40K | |
| 99188 | <1% | 1,585 | $29K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 608 | $26K |
| 90710 | <1% | 2,392 | $26K | |
| 90651 | <1% | 3,437 | $25K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 361 | $20K |
| 90633 | <1% | 5,173 | $20K | |
| 90680 | <1% | 5,881 | $17K | |
| 90744 | <1% | 4,481 | $15K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 315 | $14K |
| G0008 | Administration of influenza virus vaccine | <1% | 832 | $13K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 804 | $12K |
| 90696 | <1% | 2,365 | $12K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 584 | $11K |
| 90715 | <1% | 1,940 | $8K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 90 | $8K |
| 90707 | <1% | 2,161 | $7K | |
| 90716 | <1% | 2,390 | $7K | |
| 99177 | <1% | 3,740 | $5K | |
| 96127 | <1% | 1,710 | $5K | |
| 92551 | <1% | 3,071 | $5K | |
| 90656 | <1% | 1,796 | $5K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 176 | $4K |
| 90620 | <1% | 1,334 | $4K | |
| 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% | 1,127 | $4K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 206 | $3K |
| 90461 | <1% | 39 | $2K | |
| 0002A | <1% | 102 | $2K | |
| 90688 | <1% | 128 | $2K | |
| 0001A | <1% | 37 | $2K | |
| 0071A | <1% | 459 | $1K | |
| 90677 | <1% | 2,668 | $1K | |
| 90685 | <1% | 43 | $914.84 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,437 | $558.32 |
| 92552 | <1% | 532 | $555.71 | |
| 0072A | <1% | 408 | $390.00 | |
| 96161 | <1% | 208 | $383.18 | |
| 96160 | <1% | 1,679 | $266.58 | |
| 83655 | <1% | 667 | $248.76 | |
| 80061 | Lipid panel | <1% | 244 | $120.84 |
| 90474 | <1% | 12 | $120.00 | |
| 99173 | <1% | 164 | $92.82 | |
| 85018 | <1% | 15 | $26.58 | |
| 90619 | 0% | 1,932 | $0.00 | |
| 0081A | 0% | 25 | $0.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 55 | $0.00 |
| 36416 | 0% | 66 | $0.00 | |
| 90381 | 0% | 172 | $0.00 | |
| 0052A | 0% | 13 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 68 | $0.00 |
| 91319 | 0% | 48 | $0.00 | |
| 86580 | 0% | 17 | $0.00 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 0% | 18 | $0.00 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | 0% | 12 | $0.00 |
| 90380 | 0% | 126 | $0.00 |
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.
From NPPES
Who's on the registration
Authorized officialGIBBS, BRENDA (SR CREDENTIALING COORDINATOR)
| Provider | Location | Paid |
|---|---|---|
| Sonoran Pediatric Endocrinology & Diabetes Institute, PLC | Mesa, AZ | $705K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.