Physician
Cunningham, John
Cunningham, John was paid $1.37M by Medicaid between Oct 2018 and Dec 2024, across 21 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.
33Billing provider infoCUNNINGHAM, JOHN
SHARON, PA 16146
SHARON, PA 16146
33aNPI1912980418assigned 11/29/2005
33bProvider typePediatrics Physician
28Total paid$1.37M
24GClaims13,650
24DCodes billed21
24AFirst – last monthOct 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#73 of 1,257
Median peer was paid$45K
This provider vs. median30×
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 | 15 | $2K | |
| 2019 | 21 | $3K | |
| 2020 | 349 | $38K | |
| 2021 | 2,739 | $256K | |
| 2022 | 3,923 | $354K | |
| 2023 | 4,293 | $428K | |
| 2024incomplete | 2,310 | $294K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 100% | 6,582 | 6,155 | $1.37M |
| 90670 | <1% | 105 | 103 | $540.00 | |
| 90681 | <1% | 14 | 12 | $220.00 | |
| 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% | 358 | 354 | $175.00 |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 2,393 | 2,312 | $125.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 570 | 556 | $75.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 557 | 556 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 571 | 571 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 407 | 400 | $0.00 |
| 99173 | 0% | 677 | 677 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 212 | 210 | $0.00 |
| 90715 | 0% | 12 | 12 | $0.00 |
9 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 14 | $0.00 |
| 90633 | 0% | 12 | $0.00 | |
| 92551 | 0% | 13 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 227 | $0.00 |
| 90697 | 0% | 32 | $0.00 | |
| 3008F | 0% | 785 | $0.00 | |
| 90686 | 0% | 66 | $0.00 | |
| 90647 | 0% | 12 | $0.00 | |
| 90619 | 0% | 31 | $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.