Vanguard Medical Group, PA

Vanguard Medical Group, PA was paid $755K by Medicaid between Jan 2018 and Oct 2023, across 23 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 51% of everything it billed.

33Billing provider infoVANGUARD MEDICAL GROUP, PA
VERONA, NJ 07044

33aNPI1073674412assigned 12/12/2006

33bProvider typeSports Medicine (Family Medicine) Physician

28Total paid$755K

24GClaims18,856

24DCodes billed23

24AFirst – last monthJan 2018 – Oct 2023

Compared with peers

Next to other Sports Medicine (Family Medicine) Physician providers in New Jersey

Rank by total paid#3 of 10

Median peer was paid$22K

This provider vs. median35×

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	6,402	$266K
2019	4,987	$206K
2020	3,188	$126K
2021	3,253	$122K
2022	968	$35K
2023	58	$515.15

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	51%	9,576	8,634	$385K
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	42%	6,070	5,544	$318K
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	2.2%	447	376	$17K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	595	591	$7K
90688		<1%	304	304	$5K
0012A		<1%	128	128	$4K
90682		<1%	70	70	$3K
0011A		<1%	109	109	$3K
0064A		<1%	83	83	$2K
0001A		<1%	55	55	$2K
0002A		<1%	55	55	$2K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	37	32	$983.89

11 more codes

99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	19	$943.11
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	102	$887.45
99349		<1%	88	$817.88
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	13	$696.17
81003		<1%	996	$684.95
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	13	$495.35
0003A		<1%	12	$400.00
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	33	$383.18
93000		<1%	12	$174.35
36415	Collection of venous blood by venipuncture	<1%	26	$57.80
85018		<1%	13	$11.86

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 officialSCALES, RONISHA (CREDENTIALING SPECIALIST)