Physician
Ventura, Melencio
Ventura, Melencio was paid $474K by Medicaid between Nov 2020 and Dec 2024, across 32 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 39% of everything it billed.
33Billing provider infoVENTURA, MELENCIO
YORK, PA 17402
YORK, PA 17402
33aNPI1427144203assigned 10/05/2006
33bProvider typePediatrics Physician
28Total paid$474K
24GClaims12,063
24DCodes billed32
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#202 of 1,257
Median peer was paid$45K
This provider vs. median10×
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 | 47 | $2K | |
| 2021 | 628 | $38K | |
| 2022 | 2,458 | $107K | |
| 2023 | 4,423 | $165K | |
| 2024incomplete | 4,507 | $161K |
Box 24 · Service lines
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 | 39% | 2,271 | 2,031 | $185K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 25% | 2,307 | 2,009 | $120K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 15% | 792 | 782 | $72K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 13% | 715 | 712 | $61K |
| 99051 | 2.5% | 436 | 410 | $12K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.6% | 503 | 490 | $7K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.5% | 146 | 146 | $7K |
| 87428 | <1% | 196 | 196 | $5K | |
| 99188 | <1% | 97 | 97 | $2K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 13 | 13 | $736.74 |
| 92551 | <1% | 261 | 261 | $647.22 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,082 | 1,065 | $480.58 |
20 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 37 | $468.90 |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 12 | $431.84 |
| 90686 | <1% | 213 | $165.00 | |
| 80061 | Lipid panel | <1% | 12 | $116.40 |
| 99177 | <1% | 151 | $85.86 | |
| 96127 | <1% | 67 | $53.68 | |
| 85018 | <1% | 108 | $41.84 | |
| 96160 | <1% | 65 | $26.80 | |
| 96161 | 0% | 661 | $0.00 | |
| 90723 | 0% | 313 | $0.00 | |
| 90680 | 0% | 234 | $0.00 | |
| 90677 | 0% | 231 | $0.00 | |
| 90651 | 0% | 13 | $0.00 | |
| 90648 | 0% | 548 | $0.00 | |
| 90670 | 0% | 290 | $0.00 | |
| 90633 | 0% | 40 | $0.00 | |
| 83655 | 0% | 126 | $0.00 | |
| 90661 | 0% | 78 | $0.00 | |
| 99173 | 0% | 20 | $0.00 | |
| 90710 | 0% | 25 | $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.