Wellspan Medical Group
Wellspan Medical Group was paid $101K by Medicaid between Jan 2018 and Nov 2024, across 6 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 55% of everything it billed.
EPHRATA, PA 17522
Next to other Internal Medicine 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 | 150 | $7K | |
| 2019 | 138 | $6K | |
| 2020 | 164 | $3K | |
| 2021 | 735 | $18K | |
| 2022 | 578 | $26K | |
| 2023 | 416 | $15K | |
| 2024incomplete | 591 | $25K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 55% | 1,162 | 1,066 | $55K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 37% | 1,341 | 1,068 | $37K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.6% | 129 | 119 | $5K |
| 99336 | 2.7% | 43 | 36 | $3K | |
| 90686 | <1% | 27 | 26 | $426.87 | |
| 3008F | 0% | 70 | 70 | $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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Wellspan Medical Group | York, PA | $5.21M |
| Wellspan Medical Group | Gettysburg, PA | $1.11M |
| Wellspan Medical Group | Lititz, PA | $841K |
| Wellspan Medical Group | Lebanon, PA | $550K |
| Wellspan Medical Group | Ephrata, PA | $467K |
| Wellspan Medical Group | York, PA | $342K |
| Wellspan Medical Group | York, PA | $250K |
| Wellspan Medical Group | Lancaster, PA | $250K |
| Wellspan Medical Group | Myerstown, PA | $228K |
| Wellspan Medical Group | Ephrata, PA | $173K |
| Wellspan Medical Group | East Earl, PA | $136K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.