Physician
Gruszka, Mary Ellen
Gruszka, Mary Ellen was paid $113K by Medicaid between Jan 2018 and Oct 2020, across 16 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 38% of everything it billed.
33Billing provider infoGRUSZKA, MARY ELLEN
NORTH RIVERSIDE, IL 60546
NORTH RIVERSIDE, IL 60546
33aNPI1073506101assigned 08/24/2005
33bProvider typePediatrics Physician
28Total paid$113K
24GClaims3,588
24DCodes billed16
24AFirst – last monthJan 2018 – Oct 2020
Compared with peers
Next to other Pediatrics Physician providers in Illinois
Rank by total paid#700 of 1,805
Median peer was paid$55K
This provider vs. median2.0×
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 | 804 | $19K | |
| 2019 | 1,583 | $55K | |
| 2020 | 1,201 | $39K |
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 | 38% | 973 | 819 | $43K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 14% | 208 | 186 | $15K |
| 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 | 13% | 207 | 183 | $14K |
| 96160 | 9.2% | 829 | 686 | $10K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.4% | 124 | 103 | $9K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.5% | 64 | 59 | $5K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.5% | 212 | 187 | $4K |
| 90686 | 3.0% | 475 | 348 | $3K | |
| 96127 | 2.1% | 106 | 100 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.8% | 82 | 72 | $2K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.6% | 27 | 12 | $2K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 73 | 65 | $891.60 |
4 more codes
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 149 | $226.52 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 12 | $188.40 |
| 90648 | <1% | 13 | $83.20 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 34 | $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.