Penn State Health Community Medical Group, LLC
Penn State Health Community Medical Group, LLC was paid $366K by Medicaid between Aug 2021 and Jan 2024, across 32 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 56% of everything it billed.
MECHANICSBURG, PA 17055
Next to other Pediatrics 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 | |
|---|---|---|---|
| 2021 | 736 | $22K | |
| 2022 | 5,030 | $133K | |
| 2023 | 6,545 | $203K | |
| 2024incomplete | 117 | $7K |
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 | 56% | 3,223 | 3,066 | $206K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 18% | 823 | 811 | $66K |
| 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 | 14% | 587 | 544 | $52K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.1% | 398 | 397 | $30K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 15 | 15 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 206 | 205 | $2K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 13 | 13 | $1K |
| 92551 | <1% | 146 | 146 | $1K | |
| 83655 | <1% | 428 | 420 | $835.49 | |
| 3074F | <1% | 1,836 | 1,768 | $590.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 44 | 44 | $513.12 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 15 | 15 | $508.03 |
20 more codes
| 3078F | <1% | 1,754 | $490.00 | |
| 99173 | <1% | 124 | $478.14 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 78 | $460.11 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 13 | $388.22 |
| 99177 | <1% | 50 | $299.89 | |
| 96161 | <1% | 143 | $270.02 | |
| 99188 | <1% | 15 | $191.02 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | $185.23 |
| 90670 | <1% | 488 | $20.18 | |
| 90647 | <1% | 344 | $0.10 | |
| 90723 | <1% | 305 | $0.06 | |
| 90686 | <1% | 231 | $0.04 | |
| 90680 | <1% | 238 | $0.03 | |
| 90677 | 0% | 78 | $0.00 | |
| 3008F | 0% | 674 | $0.00 | |
| 36416 | 0% | 13 | $0.00 | |
| 90716 | 0% | 13 | $0.00 | |
| 90633 | 0% | 81 | $0.00 | |
| 90681 | 0% | 26 | $0.00 | |
| 90707 | 0% | 13 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.