Physician
Pentahealth, LLC
Pentahealth, LLC was paid $460K by Medicaid between Oct 2020 and Nov 2024, across 16 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 79% of everything it billed.
33Billing provider infoPENTAHEALTH, LLC
EXTON, PA 19341
EXTON, PA 19341
33aNPI1639787740assigned 07/15/2020
33bProvider typeInternal Medicine Physician
28Total paid$460K
24GClaims11,630
24DCodes billed16
24AFirst – last monthOct 2020 – Nov 2024
Compared with peers
Next to other Internal Medicine Physician providers in Pennsylvania
Rank by total paid#52 of 1,726
Median peer was paid$6K
This provider vs. median71×
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 | 478 | $19K | |
| 2021 | 2,833 | $115K | |
| 2022 | 3,057 | $108K | |
| 2023 | 3,303 | $133K | |
| 2024incomplete | 1,959 | $85K |
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 | 79% | 7,726 | 7,263 | $362K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 2,143 | 2,017 | $72K |
| 90682 | 4.0% | 817 | 817 | $19K | |
| 90715 | <1% | 175 | 174 | $1K | |
| 0064A | <1% | 33 | 33 | $1K | |
| 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 | <1% | 13 | 13 | $1K |
| 0011A | <1% | 23 | 23 | $976.00 | |
| G0008 | Administration of influenza virus vaccine | <1% | 110 | 105 | $739.50 |
| 0134A | <1% | 13 | 13 | $514.00 | |
| 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% | 80 | 77 | $437.50 |
| 96127 | <1% | 49 | 47 | $139.00 | |
| 86580 | <1% | 60 | 56 | $71.79 |
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 officialSEACE, JENNIFER (CREDENTIALING)
| Provider | Location | Paid |
|---|---|---|
| Gateway Medical Associates, PC | Exton, PA | $629.13 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.