Managed care
Fallon Health Weinberg
Fallon Health Weinberg was paid $333K by Medicaid between Jan 2021 and May 2024, across 12 billing codes. Its largest line is 97530, Therapeutic activities, direct patient contact, each 15 minutes — 35% of everything it billed.
33Billing provider infoFALLON HEALTH WEINBERG
AMHERST, NY 14228
AMHERST, NY 14228
33aNPI1750742367assigned 03/09/2016
33bProvider typeExclusive Provider Organization
28Total paid$333K
24GClaims10,819
24DCodes billed12
24AFirst – last monthJan 2021 – May 2024
Compared with peers
Next to other Exclusive Provider Organization providers in New York
Rank by total paid#8 of 24
Median peer was paid$123K
This provider vs. median2.7×
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 | |
|---|---|---|---|
| 2021 | 1,012 | $36K | |
| 2022 | 2,723 | $80K | |
| 2023 | 5,163 | $159K | |
| 2024incomplete | 1,921 | $58K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 35% | 3,130 | 915 | $118K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 34% | 3,874 | 1,119 | $114K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.9% | 315 | 234 | $26K |
| 97116 | 6.8% | 783 | 250 | $23K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 6.6% | 135 | 135 | $22K |
| 97164 | 3.0% | 77 | 77 | $10K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 2.7% | 338 | 100 | $9K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.9% | 113 | 95 | $6K |
| 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 | <1% | 39 | 33 | $3K |
| 97803 | <1% | 40 | 40 | $1K | |
| S5102 | Adult day care, billed per dayDay care services, adult; per diem | <1% | 1,960 | 1,755 | $86.45 |
| 91301 | 0% | 15 | 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 officialFASOLINO, COURTNEY (EXECUTIVE DIRECTOR)