Physician
Defranco, Mary Ellen
Defranco, Mary Ellen was paid $390K by Medicaid between Oct 2020 and Nov 2024, across 17 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 38% of everything it billed.
33Billing provider infoDEFRANCO, MARY ELLEN
BANGOR, PA 18013
BANGOR, PA 18013
33aNPI1346465721assigned 04/13/2007
33bProvider typePediatrics Physician
28Total paid$390K
24GClaims10,596
24DCodes billed17
24AFirst – last monthOct 2020 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#244 of 1,257
Median peer was paid$45K
This provider vs. median8.6×
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 | |
|---|---|---|---|
| 2020 | 764 | $29K | |
| 2021 | 2,680 | $103K | |
| 2022 | 2,953 | $106K | |
| 2023 | 2,500 | $88K | |
| 2024incomplete | 1,699 | $64K |
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 | 38% | 4,106 | 3,692 | $150K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 20% | 856 | 849 | $78K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 13% | 583 | 579 | $51K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 11% | 460 | 456 | $41K |
| 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 | 5.4% | 388 | 351 | $21K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.8% | 215 | 214 | $19K |
| 92551 | 4.3% | 1,869 | 1,857 | $17K | |
| 99173 | 3.1% | 1,848 | 1,836 | $12K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 92 | 92 | $694.18 |
| 90686 | <1% | 29 | 29 | $303.03 | |
| 90698 | <1% | 39 | 38 | $272.00 | |
| 83655 | <1% | 27 | 27 | $267.50 |
5 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.