Is LEHIGH VALLEY PHYSICIAN GROUP flagged for Medicaid fraud?

LEHIGH VALLEY PHYSICIAN GROUP (NPI: 1962963199) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does LEHIGH VALLEY PHYSICIAN GROUP bill Medicaid?

LEHIGH VALLEY PHYSICIAN GROUP received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Family Medicine provider. Located in WHITEHALL, PA.

What is NPI 1962963199?

NPI 1962963199 is the National Provider Identifier for LEHIGH VALLEY PHYSICIAN GROUP. They are a Family Medicine provider based in WHITEHALL, PA. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

LEHIGH VALLEY PHYSICIAN GROUP

Family Medicine·WHITEHALL, PA·NPI: 1962963199Share

Compared to Family Medicine Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $21.8M is at the 75th percentile among 19 Family Medicine providers.

Active Billing Period:2019-07→2024-12(63 months)

Total Paid

$21.8M

$21,847,786

Total Claims

280K

Beneficiaries

267K

1.1 claims/patient

Avg Cost/Claim

$78

Monthly Spending Trend

Yearly Spending

2019

$38K

+2134%

2020

$848K

+489%

2021

$5.0M

+4%

2022

$5.2M

+10%

2023

$5.7M

-12%

2024

$5.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (S9083 (Global fee, urgent care centers)) accounts for 94% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

S9083Global fee, urgent care centersSee all providers →

$20.6M

181K claims

$113.75

$103.99

1.1×

Normal range

S9083Normal range

Global fee, urgent care centers

$20.6M

181K claims · 94.1%

Your Cost: $113.75/claim|Median: $103.99

1.1× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$678K

52K claims

$13.16

$37.81

0.3×

Normal range

99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$678K

52K claims · 3.1%

Your Cost: $13.16/claim|Median: $37.81

0.3× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$259K

9,965 claims

$25.96

$53.41

0.5×

Normal range

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$259K

9,965 claims · 1.2%

Your Cost: $25.96/claim|Median: $53.41

0.5× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$156K

6,035 claims

$25.80

$57.85

0.4×

Normal range

99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$156K

6,035 claims · 0.7%

Your Cost: $25.80/claim|Median: $57.85

0.4× median

99211Office/outpatient visit, minimal complexitySee all providers →

$65K

12K claims

$5.30

$12.93

0.4×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$65K

12K claims · 0.3%

Your Cost: $5.30/claim|Median: $12.93

0.4× median

99212Office/outpatient visit, low complexitySee all providers →

$44K

4,304 claims

$10.31

$25.06

0.4×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$44K

4,304 claims · 0.2%

Your Cost: $10.31/claim|Median: $25.06

0.4× median

87651Streptococcus Group A detection, nucleic acid, amplified probeSee all providers →

$43K

7,367 claims

$5.83

$28.46

0.2×

Normal range

87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$43K

7,367 claims · 0.2%

Your Cost: $5.83/claim|Median: $28.46

0.2× median

99202Office/outpatient visit, new patient, low complexitySee all providers →

$42K

2,768 claims

$15.08

$40.11

0.4×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$42K

2,768 claims · 0.2%

Your Cost: $15.08/claim|Median: $40.11

0.4× median

87502Influenza virus detection, reverse transcription, amplified probeSee all providers →

$6K

154 claims

$37.06

$65.64

0.6×

Normal range

87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$6K

154 claims · 0.0%

Your Cost: $37.06/claim|Median: $65.64

0.6× median

87635COVID-19 SARS-CoV-2 amplified probe detectionSee all providers →

$2K

204 claims

$9.75

$39.70

0.2×

Normal range

87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$2K

204 claims · 0.0%

Your Cost: $9.75/claim|Median: $39.70

0.2× median

99000 See all providers →

$793

224 claims

$3.54

$2.30

1.5×

Normal range

99000Normal range

$793

224 claims · 0.0%

Your Cost: $3.54/claim|Median: $2.30

1.5× median

99204Office/outpatient visit, new patient, mod-high complexitySee all providers →

$608

26 claims

$23.39

$84.03

0.3×

Normal range

99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$608

26 claims · 0.0%

Your Cost: $23.39/claim|Median: $84.03

0.3× median

G2012Brief communication technology-based serviceSee all providers →

$495

51 claims

$9.71

$8.79

1.1×

Normal range

G2012Normal range

Brief communication technology-based service

$495

51 claims · 0.0%

Your Cost: $9.71/claim|Median: $8.79

1.1× median

81003Urinalysis, automated without microscopySee all providers →

$343

622 claims

$0.55

$1.48

0.4×

Normal range

81003Normal range

Urinalysis, automated without microscopy

$343

622 claims · 0.0%

Your Cost: $0.55/claim|Median: $1.48

0.4× median

96372Therapeutic injection, subcutaneous/intramuscularSee all providers →

$249

291 claims

$0.85

$9.56

0.1×

Normal range

96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$249

291 claims · 0.0%

Your Cost: $0.85/claim|Median: $9.56

0.1× median

94640Pressurized or nonpressurized inhalation treatmentSee all providers →

$158

230 claims

$0.69

$10.88

0.1×

Normal range

94640Normal range

Pressurized or nonpressurized inhalation treatment

$158

230 claims · 0.0%

Your Cost: $0.69/claim|Median: $10.88

0.1× median

J1885Injection, ketorolac tromethamine, fifteen milligramsSee all providers →

$11

1,316 claims

$0.01

$0.91

0.0×

Normal range

J1885Normal range

Injection, ketorolac tromethamine, fifteen milligrams

$11

1,316 claims · 0.0%

Your Cost: $0.01/claim|Median: $0.91

0.0× median

3078F See all providers →

88 claims

$0.00

$0.08

—

Normal range

3078FNormal range

88 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.08

J1100 See all providers →

25 claims

$0.00

$0.52

—

Normal range

J1100Normal range

25 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.52

3077F See all providers →

81 claims

$0.00

$0.12

—

Normal range

3077FNormal range

81 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.12

86580Tuberculosis (TB) skin testSee all providers →

89 claims

$0.00

$4.46

—

Normal range

86580Normal range

Tuberculosis (TB) skin test

89 claims · 0.0%

Your Cost: $0.00/claim|Median: $4.46

J0696 See all providers →

33 claims

$0.00

$1.34

—

Normal range

J0696Normal range

33 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.34

3080F See all providers →

38 claims

$0.00

$0.16

—

Normal range

3080FNormal range

38 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.16

3079F See all providers →

209 claims

$0.00

$0.12

—

Normal range

3079FNormal range

209 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.12

99421Online digital E/M, 5-10 minSee all providers →

46 claims

$0.00

$9.42

—

Normal range

99421Normal range

Online digital E/M, 5-10 min

46 claims · 0.0%

Your Cost: $0.00/claim|Median: $9.42

3074F See all providers →

159 claims

$0.00

$0.11

—

Normal range

3074FNormal range

159 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.11

T1015Clinic visit/encounter, all-inclusiveSee all providers →

54 claims

$0.00

$121.16

—

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

54 claims · 0.0%

Your Cost: $0.00/claim|Median: $121.16

J7620 See all providers →

694 claims

$0.00

$0.14

—

Normal range

J7620Normal range

694 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.14

3075F See all providers →

70 claims

$0.00

$0.15

—

Normal range

3075FNormal range

70 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.15

J7613Albuterol inhalation solution, concentrated, per milligramSee all providers →

661 claims

$0.00

$0.08

—

Normal range

J7613Normal range

Albuterol inhalation solution, concentrated, per milligram

661 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.08

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