Physician
Wherley, Andrew
Wherley, Andrew was paid $116K by Medicaid between Aug 2019 and Feb 2023, across 10 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 48% of everything it billed.
33Billing provider infoWHERLEY, ANDREW
PONTIAC, IL 61764
PONTIAC, IL 61764
33aNPI1316300593assigned 04/04/2016
33bProvider typeFamily Medicine Physician
28Total paid$116K
24GClaims3,024
24DCodes billed10
24AFirst – last monthAug 2019 – Feb 2023
Compared with peers
Next to other Family Medicine Physician providers in Illinois
Rank by total paid#871 of 2,947
Median peer was paid$43K
This provider vs. median2.7×
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 | |
|---|---|---|---|
| 2019 | 358 | $12K | |
| 2020 | 838 | $29K | |
| 2021 | 955 | $37K | |
| 2022 | 667 | $30K | |
| 2023 | 206 | $9K |
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 | 48% | 1,372 | 1,190 | $56K |
| 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 | 32% | 615 | 537 | $37K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 6.5% | 461 | 359 | $8K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 4.8% | 160 | 144 | $6K |
| 90686 | 3.1% | 276 | 211 | $4K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.6% | 46 | 38 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.3% | 18 | 18 | $2K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.0% | 17 | 14 | $1K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 33 | 28 | $439.60 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 26 | 26 | $342.47 |
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.