ST MARY MEDICAL CENTER
NPI: 1548491582
· BENSALEM, PA 19020
· Obstetrics & Gynecology Physician
· NPI assigned 08/06/2009
$156K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: SPALLUCCI, MARYANNE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
719 |
$27K |
| 2019 |
813 |
$24K |
| 2020 |
390 |
$23K |
| 2021 |
1,139 |
$83K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,841 |
1,555 |
$118K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
476 |
459 |
$34K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
160 |
147 |
$2K |
| 90744 |
|
71 |
71 |
$710.00 |
| 90715 |
|
28 |
28 |
$650.40 |
| 90680 |
|
37 |
37 |
$370.00 |
| 90723 |
|
26 |
26 |
$260.00 |
| 90648 |
|
25 |
25 |
$250.00 |
| 90670 |
|
25 |
25 |
$250.00 |
| 90686 |
|
12 |
12 |
$232.80 |
| 99173 |
|
13 |
13 |
$123.11 |
| 96161 |
|
321 |
309 |
$3.48 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26 |
26 |
$0.00 |