Physician
Tidalhealth Physician Network, INC.
Tidalhealth Physician Network, INC. was paid $8.80M by Medicaid between Jan 2018 and Dec 2024, across 134 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 31% of everything it billed.
33Billing provider infoTIDALHEALTH PHYSICIAN NETWORK, INC.
SEAFORD, DE 19973
SEAFORD, DE 19973
33aNPI1467534636assigned 10/19/2006
33bProvider typeFamily Medicine Physician
28Total paid$8.80M
24GClaims409,196
24DCodes billed134
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Delaware
Rank by total paid#4 of 97
Median peer was paid$101K
This provider vs. median87×
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.
Entity ProliferationAuthorized official PELOT, WILLIAM controls 15+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 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 | |
| 2024incomplete | 49,573 | $955K |
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 | 31% | 60,080 | 45,954 | $2.72M |
| 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% | 68,862 | 49,741 | $2.16M |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 5.5% | 6,576 | 5,080 | $483K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 4.5% | 1,009 | 843 | $393K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.1% | 6,069 | 4,513 | $276K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.1% | 13,420 | 9,388 | $271K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.3% | 3,381 | 2,609 | $198K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.9% | 2,728 | 2,061 | $169K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.8% | 6,830 | 1,883 | $155K |
| S0612 | Annual gynecological examination, established patient | 1.6% | 2,783 | 2,362 | $140K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 1.6% | 1,601 | 1,308 | $139K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.5% | 1,786 | 1,410 | $128K |
122 more codes
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 1.4% | 799 | $119K |
| 99223 | Prolong inpt eval add15 m | 1.3% | 1,746 | $114K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.2% | 2,041 | $105K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 2,851 | $87K |
| 99442 | <1% | 2,416 | $82K | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 2,451 | $76K |
| 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | <1% | 52 | $51K |
| 20610 | <1% | 1,861 | $48K | |
| 59514 | <1% | 185 | $46K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 584 | $46K |
| 97803 | <1% | 2,432 | $43K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 1,142 | $39K |
| 99205 | Prolong outpt/office vis | <1% | 372 | $38K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 4,338 | $36K |
| 59430 | <1% | 497 | $36K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 613 | $35K |
| 59410 | <1% | 131 | $33K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 442 | $31K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 7,681 | $30K |
| 90686 | <1% | 3,732 | $30K | |
| 99443 | <1% | 1,373 | $27K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 285 | $23K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 2,038 | $23K |
| 76801 | <1% | 542 | $20K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 6,780 | $20K |
| 90715 | <1% | 1,838 | $20K | |
| 99441 | <1% | 1,051 | $18K | |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 445 | $16K |
| 99385 | <1% | 449 | $16K | |
| 43775 | <1% | 22 | $16K | |
| 99221 | <1% | 371 | $16K | |
| 90682 | <1% | 681 | $13K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 300 | $13K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 38,709 | $12K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 603 | $12K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 548 | $12K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 68 | $11K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 436 | $11K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,645 | $10K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | <1% | 18 | $10K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 319 | $10K |
| 93000 | <1% | 1,236 | $9K | |
| 3074F | <1% | 28,928 | $8K | |
| 99495 | <1% | 221 | $7K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 293 | $7K |
| 11981 | <1% | 133 | $6K | |
| 59515 | <1% | 30 | $5K | |
| 81003 | <1% | 9,690 | $5K | |
| 76830 | Ultrasound, transvaginal | <1% | 194 | $5K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 1,314 | $4K |
| S0610 | Annual gynecological examination, new patient | <1% | 49 | $4K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 194 | $4K |
| 94726 | <1% | 906 | $4K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 832 | $4K |
| 3078F | <1% | 23,672 | $3K | |
| 3079F | <1% | 13,252 | $3K | |
| 94729 | <1% | 920 | $3K | |
| 81025 | <1% | 1,460 | $2K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 107 | $2K |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | <1% | 7,679 | $2K |
| 90670 | <1% | 177 | $2K | |
| 99386 | <1% | 13 | $2K | |
| 90961 | <1% | 41 | $2K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 548 | $2K |
| 3044F | <1% | 7,426 | $2K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 340 | $2K |
| 99234 | <1% | 16 | $2K | |
| 94060 | <1% | 370 | $1K | |
| 90651 | <1% | 65 | $1K | |
| 95251 | <1% | 69 | $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) | <1% | 162 | $1K |
| 99406 | <1% | 964 | $1K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 51 | $1K |
| 59025 | Fetal non-stress test | <1% | 134 | $998.62 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,052 | $944.94 |
| 95806 | <1% | 19 | $905.23 | |
| 90656 | <1% | 64 | $890.75 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | <1% | 2,972 | $866.26 |
| 1100F | <1% | 349 | $685.22 | |
| 90734 | <1% | 43 | $640.03 | |
| 90732 | <1% | 19 | $514.52 | |
| 82947 | <1% | 830 | $463.46 | |
| 84703 | <1% | 161 | $452.20 | |
| 86580 | <1% | 317 | $450.85 | |
| G0008 | Administration of influenza virus vaccine | <1% | 572 | $326.90 |
| 3052F | <1% | 873 | $316.26 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 1,465 | $270.44 |
| 82962 | <1% | 52 | $248.94 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 16 | $244.93 |
| 95811 | <1% | 95 | $244.36 | |
| 3051F | <1% | 1,733 | $242.61 | |
| 3080F | <1% | 4,683 | $220.00 | |
| 3075F | <1% | 6,871 | $200.00 | |
| 87210 | <1% | 107 | $177.87 | |
| 94618 | <1% | 27 | $163.04 | |
| 58300 | <1% | 12 | $162.17 | |
| 99496 | <1% | 14 | $128.97 | |
| 94727 | <1% | 27 | $95.37 | |
| 94375 | <1% | 23 | $93.07 | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 14 | $78.34 |
| 90662 | <1% | 142 | $58.08 | |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | <1% | 183 | $52.02 |
| 90694 | <1% | 71 | $30.50 | |
| 94010 | <1% | 29 | $26.72 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 43 | $26.03 |
| 3046F | <1% | 1,293 | $18.60 | |
| 81001 | <1% | 63 | $5.86 | |
| 3045F | 0% | 290 | $0.00 | |
| 3077F | 0% | 6,143 | $0.00 | |
| 3288F | 0% | 4,132 | $0.00 | |
| 73630 | 0% | 18 | $0.00 | |
| S9083 | Global fee urgent care centers | 0% | 68 | $0.00 |
| 1124F | 0% | 28 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 29 | $0.00 |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 0% | 20 | $0.00 |
| 71046 | Radiologic examination, chest; 2 views | 0% | 14 | $0.00 |
| 90461 | 0% | 15 | $0.00 | |
| 1101F | 0% | 2,611 | $0.00 | |
| G0009 | Administration of pneumococcal vaccine | 0% | 32 | $0.00 |
| 3048F | 0% | 29 | $0.00 | |
| 3008F | 0% | 17 | $0.00 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | 0% | 18 | $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.
From NPPES
Who's on the registration
Authorized officialPELOT, WILLIAM (CHIEF ADMINISTRATOR OFFICER)
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.