Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC

NPI: 1104404441 · MECHANICSBURG, PA 17055 · Pediatrics Physician · NPI assigned 03/30/2021

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official TINCH, PAULA controls 20+ related entities in our dataset. Read more

$366K
Total Medicaid Paid
12,428
Total Claims
11,943
Beneficiaries
32
Codes Billed
2021-08
First Month
2024-01
Last Month

Provider Details

Authorized OfficialTINCH, PAULA (CFO)
Parent OrganizationPENN STATE HEALTH
NPI Enumeration Date03/30/2021

Related Entities

Other providers sharing the same authorized official: TINCH, PAULA

ProviderCityStateTotal Paid
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $226.97M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $25.15M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $21.62M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $14.54M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $14.22M
WESTERN NEW YORK MEDICAL PRACTICE P.C. ROCHESTER NY $13.41M
ROCHESTER GENERAL HOSPITAL SODUS NY $11.31M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $10.05M
BEHAVIORAL HEALTH NETWORK, INC. ROCHESTER NY $6.84M
WESTERN NEW YORK MEDICAL PRACTICE, P.C. GENEVA NY $6.32M
CLIFTON SPRINGS SANITARIUM CO CLIFTON SPRINGS NY $1.80M
NEWARK WAYNE COMMUNITY HOSPITAL-LAB NEWARK NY $1.61M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $281K
NEWARK WAYNE COMMUNITY HOSPITAL NEWARK NY $176K
ROCHESTER GENERAL HOSPITAL WEBSTER NY $135K
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC CAMP HILL PA $56K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $54K
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC HARRISBURG PA $23K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $9K
WESTERN NEW YORK MEDICAL PRACTICE PC ROCHESTER NY $9K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 736 $22K
2022 5,030 $133K
2023 6,545 $203K
2024 117 $7K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3,223 3,066 $206K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 823 811 $66K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 587 544 $52K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 398 397 $30K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 15 15 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 206 205 $2K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 13 13 $1K
92551 146 146 $1K
83655 428 420 $835.49
3074F 1,836 1,768 $590.00
90472 Immunization administration, each additional vaccine (list separately) 44 44 $513.12
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 15 15 $508.03
3078F 1,754 1,689 $490.00
99173 124 121 $478.14
96110 Developmental screening, with scoring and documentation, per standardized instrument 78 69 $460.11
90460 Immunization administration through 18 years of age via any route, first or only component 13 13 $388.22
99177 50 50 $299.89
96161 143 140 $270.02
99188 15 12 $191.02
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 13 12 $185.23
90670 488 482 $20.18
90647 344 326 $0.10
90723 305 303 $0.06
90686 231 201 $0.04
90680 238 237 $0.03
90677 78 43 $0.00
3008F 674 660 $0.00
36416 13 12 $0.00
90716 13 12 $0.00
90633 81 80 $0.00
90681 26 25 $0.00
90707 13 12 $0.00