Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Pennsylvania (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Wellspan Medical Group (NPI 1073064796)

Field	Value
Entity Type	Organization
Organization	Wellspan Medical Group
Address	2339 S George St
City	York
State	PA
ZIP	17403
Taxonomy	Pediatrics Physician
NPI Enumerated	October 18, 2016

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

68 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	60,590	$50	$2.8M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,550	$100	$1.7M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	23,320	$70	$1.7M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,190	$90	$1.6M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10,100	$100	$959.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3,270	$100	$323.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	10,370	$10	$134.8K
0241U	N/A	1,990	$40	$77.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	10,980	$10	$65.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	3,500	$20	$56K

Showing 1–10 of 68

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.

Claims Volume vs. Pennsylvania Distribution

Wellspan Medical Group — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

68 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	565	980	310	$50	$136.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4	820	230	$80	$71.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	40	8,160	210	$60	$68.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5	660	180	$70	$63.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	14	8,870	240	$40	$56.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7	870	160	$70	$48.2K
0241U	N/A	22	190	180	$60	$46.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	620	1,210	100	$90	$45K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	218	410	320	$10	$37.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	16	730	90	$70	$31.5K

Showing 1–10 of 68

Related Providers

Other providers that share a Tax Identification Number (TIN) with Wellspan Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
York Hospital	PA	General Acute Care Hospital	$0	$40.7M
Wellspan Medical Group	PA	Psychiatry Physician	$0	$22.3M
The Good Samaritan Hospital Of Lebanon, Pennsylvania	PA	General Acute Care Hospital	$0	$18.2M
The Chambersburg Hospital	PA	General Acute Care Hospital	$0	$10.3M
Gsh Home Med Care LLC	PA	Oxygen Equipment & Supplies (DME)	$0	$6.5M
York Hospital	PA	Family Medicine Physician	$0	$6.2M
York Hospital	ME	General Acute Care Hospital	$0	$5.8M
Haiyun Wang	PA	Hematology & Oncology Physician	$2M	$0
Joyce Huang	PA	Hematology & Oncology Physician	$1.7M	$0

Nearby Providers

Other providers in the same ZIP code as Wellspan Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family First Health Corporation	PA	Federally Qualified Health Center (FQHC)	$0	$6.4M
Joseph Kannarkatt	PA	Hematology & Oncology Physician	$1.7M	$0
Chanh Huynh	PA	Hematology & Oncology Physician	$1.4M	$430
Dan Sotirescu	PA	Hematology & Oncology Physician	$1.4M	$0
Apple Hill Surgical Center Partners	PA	Ambulatory Surgical Clinic/Center	$996.2K	$283.1K
Daniel Efiom-ekaha	PA	Hematology & Oncology Physician	$1.2M	$0
Creston Tate	PA	Family Medicine Physician	$18.1K	$1.1M
Grigori Okoev	PA	Hematology & Oncology Physician	$905.2K	$0
York Endoscopy Center LLC	PA	Ambulatory Surgical Clinic/Center	$458K	$14.8K
Yi Zhou	PA	Vascular Surgery Physician	$458.3K	$0

Wellspan Medical Group — Billing Profile & Reimbursement Data

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Wellspan Medical Group — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References