Physician
Upmc Community Medicine INC
Upmc Community Medicine INC was paid $1.53M by Medicaid between Jan 2018 and Dec 2024, across 87 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 29% of everything it billed.
33Billing provider infoUPMC COMMUNITY MEDICINE INC
PITTSBURGH, PA 15213
PITTSBURGH, PA 15213
33aNPI1588622294assigned 05/02/2006
33bProvider typeSurgery Physician
28Total paid$1.53M
24GClaims86,332
24DCodes billed87
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Surgery Physician providers in Pennsylvania
Rank by total paid#7 of 190
Median peer was paid$3K
This provider vs. median459×
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 | 3,081 | $90K | |
| 2019 | 2,016 | $58K | |
| 2020 | 5,802 | $101K | |
| 2021 | 28,241 | $500K | |
| 2022 | 19,318 | $336K | |
| 2023 | 15,954 | $244K | |
| 2024incomplete | 11,920 | $201K |
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 | 29% | 19,702 | 18,433 | $445K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 23% | 16,257 | 15,189 | $349K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 9.8% | 4,204 | 2,733 | $149K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 8.5% | 5,221 | 1,750 | $131K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 5.0% | 1,126 | 432 | $77K |
| 99222 | Initial hospital care, per day, moderate complexity | 3.8% | 892 | 834 | $58K |
| 90682 | 2.0% | 2,913 | 2,857 | $31K | |
| 90715 | 2.0% | 2,559 | 2,479 | $30K | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 1.6% | 1,151 | 1,139 | $24K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.5% | 1,119 | 655 | $23K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.4% | 832 | 788 | $21K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.2% | 340 | 331 | $19K |
75 more codes
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.1% | 3,104 | $17K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 863 | $15K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 145 | $12K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 228 | $12K |
| 99337 | <1% | 156 | $11K | |
| 90732 | <1% | 269 | $11K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 473 | $11K |
| 90674 | <1% | 3,190 | $9K | |
| 99350 | Prolong home eval add 15m | <1% | 190 | $7K |
| 90670 | <1% | 800 | $6K | |
| G9012 | Other specified case management service not elsewhere classified | <1% | 95 | $6K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 29 | $5K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 518 | $5K |
| 90746 | <1% | 138 | $5K | |
| G0008 | Administration of influenza virus vaccine | <1% | 1,751 | $4K |
| 99307 | <1% | 184 | $3K | |
| 95886 | <1% | 67 | $3K | |
| 90734 | <1% | 621 | $3K | |
| 99243 | <1% | 55 | $3K | |
| 90686 | <1% | 380 | $3K | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 553 | $3K |
| 99336 | <1% | 61 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 112 | $2K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 55 | $1K |
| 90651 | <1% | 493 | $1K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 2,357 | $1K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 37 | $1K |
| 20610 | <1% | 69 | $1K | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 542 | $1K |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 125 | $1K |
| 36415 | Collection of venous blood by venipuncture | <1% | 592 | $1K |
| 99349 | <1% | 38 | $960.61 | |
| 99253 | <1% | 24 | $925.88 | |
| 73130 | <1% | 42 | $865.40 | |
| 86580 | <1% | 2,082 | $650.25 | |
| 99310 | Prolong nursin fac eval 15m | <1% | 57 | $590.88 |
| G0009 | Administration of pneumococcal vaccine | <1% | 154 | $464.93 |
| 90648 | <1% | 67 | $420.00 | |
| 90633 | <1% | 235 | $348.00 | |
| 90723 | <1% | 58 | $278.10 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 1,908 | $240.20 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 15 | $180.68 |
| 92551 | <1% | 27 | $165.88 | |
| 81025 | <1% | 12 | $105.59 | |
| 99173 | <1% | 42 | $98.28 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 14 | $93.00 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 43 | $49.01 |
| 90480 | <1% | 13 | $34.00 | |
| 3078F | <1% | 71 | $30.00 | |
| 80305 | <1% | 13 | $11.97 | |
| 3074F | <1% | 13 | $10.00 | |
| 4010F | <1% | 15 | $10.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 3,317 | $0.00 |
| 90677 | 0% | 1,439 | $0.00 | |
| 1101F | 0% | 267 | $0.00 | |
| 90739 | 0% | 98 | $0.00 | |
| J1010 | Injection, methylprednisolone acetate, 1 mg | 0% | 28 | $0.00 |
| 90716 | 0% | 19 | $0.00 | |
| 90656 | 0% | 39 | $0.00 | |
| 0001A | 0% | 28 | $0.00 | |
| 90696 | 0% | 14 | $0.00 | |
| 3061F | 0% | 12 | $0.00 | |
| 90673 | 0% | 318 | $0.00 | |
| 91322 | 0% | 142 | $0.00 | |
| 90661 | 0% | 570 | $0.00 | |
| 3288F | 0% | 293 | $0.00 | |
| 0124A | 0% | 57 | $0.00 | |
| 91312 | 0% | 60 | $0.00 | |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 0% | 16 | $0.00 |
| 0003A | 0% | 18 | $0.00 | |
| 91300 | 0% | 12 | $0.00 | |
| 90707 | 0% | 34 | $0.00 | |
| 1090F | 0% | 12 | $0.00 | |
| 0054A | 0% | 13 | $0.00 | |
| 90710 | 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.
From NPPES
Who's on the registration
Authorized officialDEVLIN), PATRICIA (DIRECTOR, REVENUE CYCLE)