Semelka, Michael

Semelka, Michael was paid $24K by Medicaid between Nov 2020 and Nov 2024, across 5 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 78% of everything it billed.

33Billing provider infoSEMELKA, MICHAEL
MT PLEASANT, PA 15666

33aNPI1639112840assigned 06/14/2006

33bProvider typeFamily Medicine Physician

28Total paid$24K

24GClaims980

24DCodes billed5

24AFirst – last monthNov 2020 – Nov 2024

Compared with peers

Next to other Family Medicine Physician providers in Pennsylvania

Rank by total paid#1,288 of 2,756

Median peer was paid$19K

This provider vs. median1.2×

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
2020	89	$2K
2021	80	$2K
2022	203	$5K
2023	368	$8K
2024incomplete	240	$7K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	78%	634	610	$18K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	13%	144	142	$3K
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	9.6%	55	55	$2K
3008F		0%	106	102	$0.00
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	41	40	$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.