Physician
Valley Pediatric Group, PLC
Valley Pediatric Group, PLC was paid $6.97M by Medicaid between Jan 2018 and Dec 2024, across 43 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 42% of everything it billed.
33Billing provider infoVALLEY PEDIATRIC GROUP, PLC
WAYNESBORO, VA 22980
WAYNESBORO, VA 22980
33aNPI1003865122assigned 05/08/2006
33bProvider typePediatrics Physician
28Total paid$6.97M
24GClaims186,394
24DCodes billed43
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Virginia
Rank by total paid#17 of 817
Median peer was paid$29K
This provider vs. median238×
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 | 5,976 | $218K | |
| 2019 | 31,131 | $1.13M | |
| 2020 | 28,478 | $921K | |
| 2021 | 27,491 | $912K | |
| 2022 | 32,562 | $1.34M | |
| 2023 | 30,730 | $1.31M | |
| 2024incomplete | 30,026 | $1.14M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 42% | 49,196 | 45,050 | $2.92M |
| 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 | 21% | 17,291 | 16,295 | $1.44M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10% | 9,428 | 9,089 | $706K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.2% | 7,739 | 7,481 | $572K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.4% | 4,215 | 4,058 | $310K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.4% | 2,921 | 2,833 | $234K |
| 92551 | 2.4% | 17,836 | 17,158 | $165K | |
| 90686 | 1.5% | 8,883 | 8,572 | $101K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.1% | 2,704 | 2,562 | $76K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 5,691 | 5,364 | $63K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,624 | 2,218 | $55K |
| 90670 | <1% | 2,544 | 2,487 | $55K |
31 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 3,287 | $41K |
| 99173 | <1% | 17,485 | $40K | |
| 96127 | <1% | 4,473 | $22K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 554 | $20K |
| 87428 | <1% | 658 | $19K | |
| 90651 | <1% | 490 | $16K | |
| 99177 | <1% | 3,728 | $14K | |
| 90698 | <1% | 894 | $14K | |
| 90656 | <1% | 908 | $14K | |
| 90685 | <1% | 943 | $12K | |
| 99072 | <1% | 7,901 | $11K | |
| 90680 | <1% | 513 | $9K | |
| 90633 | <1% | 636 | $9K | |
| 90671 | <1% | 172 | $5K | |
| 90619 | <1% | 184 | $5K | |
| 90716 | <1% | 251 | $5K | |
| 90707 | <1% | 283 | $4K | |
| 96161 | <1% | 1,554 | $4K | |
| 99188 | <1% | 182 | $4K | |
| 90700 | <1% | 296 | $4K | |
| 90744 | <1% | 148 | $2K | |
| 85018 | <1% | 664 | $1K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 95 | $844.18 |
| 91321 | <1% | 27 | $638.90 | |
| 90713 | <1% | 55 | $589.21 | |
| 90734 | <1% | 25 | $560.35 | |
| 83655 | <1% | 41 | $449.88 | |
| 87807 | <1% | 15 | $147.68 | |
| 90715 | <1% | 16 | $144.65 | |
| 99051 | <1% | 135 | $108.28 | |
| 3008F | 0% | 8,709 | $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.
From NPPES
Who's on the registration
Authorized officialHUMPHRIES, GINA (ADMINISTRATOR)