Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidPaul Wallace
    Ask Trek AI about this page

    Paul Wallace — Billing Profile & Reimbursement Data

    NPI 1639287212 · Philadelphia, PA · Internal Medicine Physician

    Customize your policy alerts

    Sign up for Paul Wallace — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Paul Wallace is a internal medicine physician provider located in Philadelphia, Pennsylvania. This profile covers 13 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationPaul Wallace
    Address7806 Cresheim Rd
    CityPhiladelphia
    StatePA
    ZIP19118
    TaxonomyInternal Medicine Physician
    NPI EnumeratedAugust 25, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$56.1K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    13 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…210$80$17.3K
    99350The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…110$140$14.9K
    93308The provider performs a limited or follow–up transthoracic echocardiography to obtain a two dimensional (2D) image of the heart through the chest wall. It is a limited examination of a focused…80$80$6K
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit40$130$5.4K
    99496The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…10$220$2.8K
    76604The provider uses ultrasound to evaluate the pleural spaces for the presence of fluid or masses of the chest, upper back, chest wall, or mediastinum.60$40$2.6K
    99497The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…20$60$1.5K
    G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review…40$40$1.4K
    99348The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…20$50$1.1K
    99344The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…10$80$1.1K

    Showing 1–10 of 13

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    13 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9934915370070$90$13.8K
    993507930050$120$12.5K
    G04393,3125,25060$110$9.5K
    9934845856060$50$5.2K
    9949680399020$180$4.3K
    99491233060$60$4.3K
    9949763992040$60$4K
    9934410013020$100$2.8K
    G00085,4326,67050$30$2.4K
    G018010985020$40$1K

    Showing 1–10 of 13

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Columbus Radiology CorpOHDiagnostic Radiology Physician$0$49.9M
    Holy Redeemer Health SystemPAGeneral Acute Care Hospital$0$9.9M
    Joel WolfPAVascular & Interventional Radiology Physician$1.3M$4.7K
    Holy Redeemer Ambulatory Surgery Center, LLCPAAmbulatory Surgical Clinic/Center$1.1M$0
    Jascha RubinPAHematology & Oncology Physician$747.8K$0
    Thomas ReillyNJDiagnostic Radiology Physician$618.2K$50
    Matthew NagorskyPAOtolaryngology Physician$453.4K$63.3K
    Caitlin HardyNJDiagnostic Radiology Physician$468.5K$0
    Daniel LucasAZDiagnostic Radiology Physician$298.3K$164.6K
    Bruce KlugherzPACardiovascular Disease Physician$425.7K$0

    Nearby Providers

    Other providers in the same ZIP code as Paul Wallace, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Chestnut Hill Hospital, LLCPAGeneral Acute Care Hospital$0$9.5M
    Todd AaronPAInternal Medicine Physician$553.4K$12.1K
    Ajay SinghPADiagnostic Radiology Physician$290.3K$6K
    Parul PatelPACardiovascular Disease Physician$219.9K$350
    Pennsylvania Cvs Pharmacy, L.L.C.PAPharmacy$159.9K$0
    Trey KamplainPADiagnostic Radiology Physician$152.5K$3.7K
    Thomas DelgiornoPANephrology Physician$147.7K$0
    David UdisPADiagnostic Radiology Physician$139.2K$1.5K
    Samer BashaPAEmergency Medicine Physician$100.6K$16.5K
    Shaun LatshawPAFoot & Ankle Surgery Podiatrist$89.3K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Pennsylvania Distribution
    Paul Wallace — 1 of 13 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Pennsylvania