University of Penn - Medical Group
University of Penn - Medical Group was paid $981K by Medicaid between Jan 2018 and Nov 2024, across 15 billing codes. Its largest line is 95810, Polysomnography; sleep staging with 4 or more additional parameters — 37% of everything it billed.
PHILADELPHIA, PA 19104
Next to other Pulmonary Disease 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 | |
|---|---|---|---|
| 2018 | 58 | $525.00 | |
| 2020 | 363 | $38K | |
| 2021 | 1,714 | $176K | |
| 2022 | 2,631 | $289K | |
| 2023 | 2,673 | $266K | |
| 2024incomplete | 3,102 | $211K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 37% | 2,021 | 1,984 | $364K |
| 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 | 25% | 3,508 | 3,330 | $245K |
| 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 | 20% | 1,744 | 1,712 | $200K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 5.8% | 548 | 486 | $56K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.8% | 758 | 723 | $37K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 2.3% | 347 | 151 | $23K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.0% | 269 | 267 | $20K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 1.3% | 72 | 72 | $13K |
| 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% | 1,001 | 938 | $8K |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | <1% | 85 | 85 | $6K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | <1% | 55 | 28 | $5K |
| 99254 | <1% | 30 | 26 | $4K |
3 more codes
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.