Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › DE › SEAFORD › TIDALHEALTH PHYSICIAN NETWORK, INC.

TIDALHEALTH PHYSICIAN NETWORK, INC.

NPI: 1467534636 · SEAFORD, DE 19973 · Family Medicine Physician · NPI assigned 10/19/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official PELOT, WILLIAM controls 15+ related entities in our dataset. Read more

$8.80M
Total Medicaid Paid
409,196
Total Claims
292,053
Beneficiaries
134
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPELOT, WILLIAM (CHIEF ADMINISTRATOR OFFICER)
NPI Enumeration Date10/19/2006

Related Entities

Other providers sharing the same authorized official: PELOT, WILLIAM

ProviderCityStateTotal Paid
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $11.72M
TIDALHEALTH PHYSICIAN NETWORK, INC. SEAFORD DE $2.86M
TIDALHEALTH PRIMARY CARE, LLC SALISBURY MD $2.44M
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $841K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $39K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $32K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $9K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $5K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $3K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $3K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $2K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $1K
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $562.99
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $535.19
TIDALHEALTH SPECIALTY CARE, LLC SALISBURY MD $308.26

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 39,008 $199K
2019 43,975 $888K
2020 37,271 $1.80M
2021 48,522 $1.82M
2022 68,852 $1.59M
2023 121,995 $1.55M
2024 49,573 $955K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 60,080 45,954 $2.72M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 68,862 49,741 $2.16M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 6,576 5,080 $483K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 1,009 843 $393K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 6,069 4,513 $276K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 13,420 9,388 $271K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 3,381 2,609 $198K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 2,728 2,061 $169K
99232 Subsequent hospital care, per day, moderate complexity 6,830 1,883 $155K
S0612 Annual gynecological examination, established patient 2,783 2,362 $140K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,601 1,308 $139K
99215 Prolong outpt/office vis 1,786 1,410 $128K
45380 Colonoscopy, flexible; with biopsy, single or multiple 799 648 $119K
99223 Prolong inpt eval add15 m 1,746 1,208 $114K
99222 Initial hospital care, per day, moderate complexity 2,041 1,414 $105K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 2,851 1,246 $87K
99442 2,416 1,785 $82K
76819 Fetal biophysical profile; without non-stress testing 2,451 973 $76K
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care 52 39 $51K
20610 1,861 1,299 $48K
59514 185 143 $46K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 584 520 $46K
97803 2,432 1,760 $43K
99233 Prolong inpt eval add15 m 1,142 379 $39K
99205 Prolong outpt/office vis 372 298 $38K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 4,338 2,932 $36K
59430 497 447 $36K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 613 552 $35K
59410 131 82 $33K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 442 97 $31K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 7,681 5,906 $30K
90686 3,732 2,834 $30K
99443 1,373 1,087 $27K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 285 251 $23K
J1050 Injection, medroxyprogesterone acetate, 1 mg 2,038 1,561 $23K
76801 542 373 $20K
83036 Hemoglobin; glycosylated (A1C) 6,780 5,154 $20K
90715 1,838 1,380 $20K
99441 1,051 674 $18K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 445 390 $16K
99385 449 249 $16K
43775 22 13 $16K
99221 371 246 $16K
90682 681 566 $13K
95810 Polysomnography; sleep staging with 4 or more additional parameters 300 278 $13K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 38,709 25,819 $12K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 603 295 $12K
99231 Subsequent hospital care, per day, straightforward or low complexity 548 319 $12K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 68 61 $11K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 436 335 $11K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,645 1,031 $10K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 18 12 $10K
99238 Hospital discharge day management, 30 minutes or less 319 216 $10K
93000 1,236 978 $9K
3074F 28,928 20,532 $8K
99495 221 181 $7K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 293 248 $7K
11981 133 120 $6K
59515 30 14 $5K
81003 9,690 6,198 $5K
76830 Ultrasound, transvaginal 194 96 $5K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,314 994 $4K
S0610 Annual gynecological examination, new patient 49 36 $4K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 194 96 $4K
94726 906 719 $4K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 832 535 $4K
3078F 23,672 16,897 $3K
3079F 13,252 9,742 $3K
94729 920 721 $3K
81025 1,460 1,014 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 107 96 $2K
G8420 Bmi is documented within normal parameters and no follow-up plan is required 7,679 5,279 $2K
90670 177 145 $2K
99386 13 13 $2K
90961 41 36 $2K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 548 430 $2K
3044F 7,426 5,134 $2K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 340 170 $2K
99234 16 12 $2K
94060 370 320 $1K
90651 65 50 $1K
95251 69 66 $1K
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) 162 120 $1K
99406 964 731 $1K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 51 38 $1K
59025 Fetal non-stress test 134 120 $998.62
90472 Immunization administration, each additional vaccine (list separately) 1,052 804 $944.94
95806 19 12 $905.23
90656 64 63 $890.75
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 2,972 2,375 $866.26
1100F 349 275 $685.22
90734 43 37 $640.03
90732 19 17 $514.52
82947 830 517 $463.46
84703 161 133 $452.20
86580 317 254 $450.85
G0008 Administration of influenza virus vaccine 572 495 $326.90
3052F 873 634 $316.26
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 1,465 1,158 $270.44
82962 52 48 $248.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 16 13 $244.93
95811 95 90 $244.36
3051F 1,733 1,182 $242.61
3080F 4,683 3,304 $220.00
3075F 6,871 5,131 $200.00
87210 107 94 $177.87
94618 27 24 $163.04
58300 12 12 $162.17
99496 14 12 $128.97
94727 27 14 $95.37
94375 23 12 $93.07
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 14 12 $78.34
90662 142 123 $58.08
G8418 Bmi is documented below normal parameters and a follow-up plan is documented 183 131 $52.02
90694 71 57 $30.50
94010 29 25 $26.72
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 43 27 $26.03
3046F 1,293 873 $18.60
81001 63 57 $5.86
3045F 290 212 $0.00
3077F 6,143 4,353 $0.00
3288F 4,132 3,236 $0.00
73630 18 13 $0.00
S9083 Global fee urgent care centers 68 68 $0.00
1124F 28 24 $0.00
90460 Immunization administration through 18 years of age via any route, first or only component 29 27 $0.00
77067 Screening mammography, bilateral, including computer-aided detection 20 20 $0.00
71046 Radiologic examination, chest; 2 views 14 14 $0.00
90461 15 13 $0.00
1101F 2,611 2,064 $0.00
G0009 Administration of pneumococcal vaccine 32 28 $0.00
3048F 29 26 $0.00
3008F 17 17 $0.00
77063 Screening digital breast tomosynthesis, bilateral 18 18 $0.00