Physician
Hefner, David
Hefner, David was paid $2.17M by Medicaid between Jan 2018 and Dec 2024, across 51 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 40% of everything it billed.
33Billing provider infoHEFNER, DAVID
GROVE CITY, PA 16127
GROVE CITY, PA 16127
33aNPI1568421477assigned 03/20/2006
33bProvider typePediatrics Physician
28Total paid$2.17M
24GClaims56,662
24DCodes billed51
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#38 of 1,257
Median peer was paid$45K
This provider vs. median48×
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 | |
|---|---|---|---|
| 2018 | 381 | $31K | |
| 2019 | 188 | $12K | |
| 2020 | 1,148 | $54K | |
| 2021 | 9,812 | $404K | |
| 2022 | 11,366 | $465K | |
| 2023 | 17,105 | $614K | |
| 2024incomplete | 16,662 | $584K |
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 | 40% | 11,100 | 9,833 | $856K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 6,364 | 5,803 | $318K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.2% | 2,173 | 2,170 | $200K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.0% | 2,164 | 2,160 | $195K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.9% | 1,888 | 1,859 | $171K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 7.5% | 1,797 | 1,791 | $162K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 5.7% | 1,026 | 848 | $124K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.5% | 2,196 | 2,108 | $32K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 559 | 552 | $21K |
| 99188 | <1% | 962 | 961 | $19K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,203 | 593 | $15K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 256 | 249 | $10K |
39 more codes
| 87428 | <1% | 293 | $10K | |
| 90686 | <1% | 1,131 | $5K | |
| 90648 | <1% | 1,334 | $4K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 37 | $3K |
| 90670 | <1% | 855 | $3K | |
| 90680 | <1% | 900 | $3K | |
| 90723 | <1% | 980 | $3K | |
| 81002 | <1% | 537 | $2K | |
| 90633 | <1% | 564 | $1K | |
| 96127 | <1% | 2,125 | $1K | |
| 90734 | <1% | 109 | $1K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 2,376 | $1K |
| 96160 | <1% | 2,117 | $1K | |
| 92551 | <1% | 3,134 | $890.62 | |
| 99173 | <1% | 1,651 | $761.26 | |
| 90651 | <1% | 317 | $751.00 | |
| 0071A | <1% | 18 | $748.00 | |
| 99177 | <1% | 757 | $496.02 | |
| 90620 | <1% | 223 | $418.00 | |
| 80061 | Lipid panel | <1% | 129 | $401.06 |
| 0072A | <1% | 16 | $264.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 13 | $181.61 |
| 87807 | <1% | 13 | $161.15 | |
| 90710 | <1% | 83 | $144.00 | |
| 90696 | <1% | 60 | $143.00 | |
| 90715 | <1% | 77 | $108.00 | |
| 85018 | <1% | 215 | $71.86 | |
| 83655 | <1% | 430 | $52.99 | |
| 96161 | 0% | 1,297 | $0.00 | |
| 90619 | 0% | 279 | $0.00 | |
| 90677 | 0% | 459 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 792 | $0.00 |
| 90716 | 0% | 65 | $0.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 27 | $0.00 |
| 90700 | 0% | 64 | $0.00 | |
| 90661 | 0% | 208 | $0.00 | |
| G9920 | Screening performed and negative | 0% | 1,193 | $0.00 |
| 90707 | 0% | 81 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 15 | $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.