Clinic
Spectrum Health Services, INC.
Spectrum Health Services, INC. was paid $11.98M by Medicaid between Jan 2018 and Dec 2024, across 61 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 98% of everything it billed.
33Billing provider infoSPECTRUM HEALTH SERVICES, INC.
PHILADELPHIA, PA 19139
PHILADELPHIA, PA 19139
33aNPI1265866107assigned 08/28/2013
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$11.98M
24GClaims94,454
24DCodes billed61
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Pennsylvania
Rank by total paid#24 of 240
Median peer was paid$909K
This provider vs. median13×
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 | 1,230 | $170K | |
| 2019 | 1,050 | $115K | |
| 2020 | 22,890 | $3.35M | |
| 2021 | 41,057 | $5.06M | |
| 2022 | 11,585 | $1.82M | |
| 2023 | 3,363 | $529K | |
| 2024incomplete | 13,279 | $930K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 98% | 54,464 | 43,213 | $11.69M |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 1,944 | 1,268 | $98K |
| 0011A | <1% | 1,837 | 1,759 | $58K | |
| 0012A | <1% | 1,538 | 1,480 | $55K | |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 792 | 650 | $38K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 9,972 | 8,412 | $15K |
| 0013A | <1% | 326 | 321 | $12K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 4,006 | 3,358 | $5K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 56 | 56 | $1K |
| 0064A | <1% | 32 | 32 | $880.00 | |
| 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 | <1% | 702 | 621 | $544.20 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 76 | 76 | $478.24 |
49 more codes
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 331 | $162.00 |
| D0210 | Intraoral - complete series of radiographic images | <1% | 536 | $108.00 |
| D0120 | Dental checkup, returning patient | <1% | 1,520 | $48.00 |
| D4346 | <1% | 78 | $43.20 | |
| D1110 | Prophylaxis - adult | <1% | 1,318 | $40.80 |
| 99173 | <1% | 527 | $40.14 | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,424 | $24.00 |
| D0140 | Limited oral evaluation - problem focused | <1% | 494 | $24.00 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 1,184 | $19.20 |
| 92551 | <1% | 175 | $12.84 | |
| D1330 | <1% | 998 | $5.00 | |
| 91301 | <1% | 1,477 | $4.18 | |
| 96127 | <1% | 1,680 | $0.55 | |
| 3008F | 0% | 1,112 | $0.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | 0% | 696 | $0.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 438 | $0.00 |
| D1351 | Sealant - per tooth | 0% | 46 | $0.00 |
| D1206 | Topical application of fluoride varnish | 0% | 592 | $0.00 |
| 3074F | 0% | 311 | $0.00 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 61 | $0.00 |
| D7140 | Extraction, erupted tooth or exposed root | 0% | 274 | $0.00 |
| D0999 | Unspecified diagnostic procedure, by report | 0% | 89 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 27 | $0.00 |
| 90688 | 0% | 86 | $0.00 | |
| 97802 | 0% | 41 | $0.00 | |
| 3079F | 0% | 56 | $0.00 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 0% | 12 | $0.00 |
| 3080F | 0% | 23 | $0.00 | |
| D0272 | Bitewings - two radiographic images | 0% | 41 | $0.00 |
| D5899 | 0% | 232 | $0.00 | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 0% | 12 | $0.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 25 | $0.00 |
| 99385 | 0% | 14 | $0.00 | |
| D0330 | Panoramic radiographic image | 0% | 524 | $0.00 |
| D1120 | Dental cleaning, child | 0% | 330 | $0.00 |
| D0270 | 0% | 83 | $0.00 | |
| D0274 | Bitewings - four radiographic images | 0% | 1,229 | $0.00 |
| 3078F | 0% | 267 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 57 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 12 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 12 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 68 | $0.00 |
| 3077F | 0% | 45 | $0.00 | |
| 97803 | 0% | 43 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 13 | $0.00 |
| 92550 | 0% | 14 | $0.00 | |
| D9110 | 0% | 28 | $0.00 | |
| D9430 | 0% | 40 | $0.00 | |
| 82948 | 0% | 14 | $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 officialHILL-MILBLBOURNE, VERONICA (PRESIDENT/CEO)