Clinic
Tidalhealth Primary Care, LLC
Tidalhealth Primary Care, LLC was paid $2.44M by Medicaid between Sep 2020 and Dec 2024, across 50 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.
33Billing provider infoTIDALHEALTH PRIMARY CARE, LLC
SALISBURY, MD 21801
SALISBURY, MD 21801
33aNPI1104453208assigned 03/26/2020
33bProvider typeCommunity Health Clinic/Center
28Total paid$2.44M
24GClaims125,039
24DCodes billed50
24AFirst – last monthSep 2020 – Dec 2024
Compared with peers
Next to other Community Health Clinic/Center providers in Maryland
Rank by total paid#4 of 14
Median peer was paid$154K
This provider vs. median16×
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.
Entity ProliferationAuthorized official PELOT, WILLIAM controls 15+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2020 | 6,770 | $134K | |
| 2021 | 18,865 | $461K | |
| 2022 | 25,488 | $575K | |
| 2023 | 36,845 | $750K | |
| 2024incomplete | 37,071 | $521K |
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 | 46% | 19,090 | 15,109 | $1.13M |
| 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 | 35% | 11,717 | 9,694 | $845K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 4.5% | 22,039 | 17,205 | $109K |
| 3074F | 2.9% | 18,509 | 13,910 | $71K | |
| 3078F | 2.0% | 13,701 | 10,232 | $48K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.1% | 319 | 225 | $26K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 1,036 | 872 | $24K |
| 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% | 218 | 175 | $23K |
| 3079F | <1% | 5,956 | 4,559 | $19K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 929 | 707 | $15K |
| 90686 | <1% | 1,088 | 836 | $15K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 125 | 82 | $12K |
38 more codes
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | <1% | 1,700 | $12K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 110 | $12K |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 12,299 | $12K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 201 | $10K |
| 3044F | <1% | 2,555 | $9K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 65 | $7K |
| 90677 | <1% | 72 | $5K | |
| 99442 | <1% | 134 | $5K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 473 | $4K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 45 | $4K |
| 3075F | <1% | 1,445 | $3K | |
| 99495 | <1% | 29 | $3K | |
| 90750 | <1% | 12 | $2K | |
| 90648 | <1% | 66 | $2K | |
| 90723 | <1% | 63 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 47 | $1K |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | <1% | 532 | $1K |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 98 | $1K |
| 3077F | <1% | 498 | $1K | |
| 99381 | <1% | 18 | $1K | |
| G0008 | Administration of influenza virus vaccine | <1% | 408 | $829.82 |
| 90715 | <1% | 22 | $731.49 | |
| 99443 | <1% | 13 | $643.19 | |
| 3080F | <1% | 214 | $380.00 | |
| 3051F | <1% | 111 | $329.75 | |
| 90713 | <1% | 13 | $321.02 | |
| 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% | 45 | $168.33 |
| 3052F | <1% | 22 | $83.40 | |
| 3046F | <1% | 19 | $58.61 | |
| 90694 | <1% | 60 | $30.50 | |
| G9664 | Patients who are currently statin therapy users or received an order (prescription) for statin therapy | <1% | 1,490 | $28.86 |
| 90656 | <1% | 13 | $19.89 | |
| 90662 | <1% | 80 | $10.37 | |
| 1101F | 0% | 3,243 | $0.00 | |
| 1111F | 0% | 17 | $0.00 | |
| 3288F | 0% | 3,764 | $0.00 | |
| 90461 | 0% | 132 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 184 | $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 officialPELOT, WILLIAM (CHIEF ADMINISTRATOR OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $11.72M |
| Tidalhealth Physician Network, INC. | Seaford, DE | $8.80M |
| Tidalhealth Physician Network, INC. | Seaford, DE | $2.86M |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $841K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $39K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $32K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $9K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $5K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $3K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $3K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $2K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $1K |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $562.99 |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $535.19 |
| Tidalhealth Specialty Care, LLC | Salisbury, MD | $308.26 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.