Lily Girson, MD
Opted out of Medicare from April 2024 to April 2028. Family Medicine (MD) in Oakmont, Pennsylvania, licensed in PA, with an NPI issued in May 2017. Their prescriptions cost Medicare Part D more than their services did: $33,633 for 424 claims, against $996.08 paid for services in 2024. Astellas Pharma US Inc was the largest of 4 companies reporting payments in 2025, $133.24 in all, mostly food and beverage.
Overview
| NPI | 1326574401 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | Yes |
| NPI issued | May 10, 2017 |
| Last updated in NPPES | Sep 21, 2020 |
| Certified by provider | Sep 21, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | MD471228 | PA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Apr 22, 2024 – Apr 22, 2028 |
| Can order and refer | Yes |
| Accepts assignment | Yes (participating) |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
Medicare services in 2024
| Medicare patients | 19 |
|---|---|
| Services billed | 32 across 6 procedure codes |
| Paid by Medicare | $996.08 |
Part D prescriptions in 2024
| Prescriptions (claims) | 424 · 973 30-day fills |
|---|---|
| Patients | 81 |
| Total drug cost | $33,633 |
| Generic share | 91% of claims |
Industry payments (Open Payments)
- 2025$133.24 · 6 payments from 4 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Astellas Pharma US Inc | $51.40 | 3 |
| Revance Therapeutics, Inc. | $49.63 | 1 |
| Exact Sciences Corporation | $16.28 | 1 |
| Amgen Inc. | $15.93 | 1 |
What the 2025 payments were for
- Food and Beverage$133.24 · 6 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 15 family medicine physicians in Oakmont · All family medicine physicians in Pennsylvania