Clinic
Pediahealth Medical Group, INC.
Pediahealth Medical Group, INC. was paid $774K by Medicaid between Jan 2018 and Nov 2024, across 62 billing codes. Its largest line is 96110, Developmental screening, with scoring and documentation, per standardized instrument — 35% of everything it billed.
33Billing provider infoPEDIAHEALTH MEDICAL GROUP, INC.
DALY CITY, CA 94015
DALY CITY, CA 94015
33aNPI1003913971assigned 09/20/2006
33bProvider typeClinic/Center
28Total paid$774K
24GClaims57,979
24DCodes billed62
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Clinic/Center providers in California
Rank by total paid#149 of 504
Median peer was paid$102K
This provider vs. median7.6×
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 | 15,955 | $269K | |
| 2019 | 12,120 | $125K | |
| 2020 | 8,831 | $120K | |
| 2021 | 6,826 | $89K | |
| 2022 | 6,019 | $82K | |
| 2023 | 3,800 | $27K | |
| 2024incomplete | 4,428 | $62K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 35% | 6,450 | 6,376 | $272K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.8% | 7,814 | 7,143 | $53K |
| 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 | 6.0% | 2,753 | 2,532 | $47K |
| 99188 | 4.1% | 1,968 | 1,956 | $32K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.7% | 1,026 | 1,019 | $29K |
| 96127 | 3.3% | 4,636 | 4,575 | $26K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.2% | 1,140 | 1,138 | $25K |
| 90656 | 2.8% | 2,004 | 1,996 | $22K | |
| 99429 | 2.8% | 935 | 924 | $22K | |
| 94010 | 2.6% | 675 | 635 | $20K | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 2.3% | 651 | 641 | $17K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.2% | 355 | 330 | $17K |
50 more codes
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.2% | 960 | $17K |
| 94016 | 2.1% | 652 | $16K | |
| 99203 | Doctor's office visit, new patient (routine) | 2.0% | 237 | $16K |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 1.9% | 740 | $15K |
| G0443 | Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes | 1.7% | 647 | $13K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 1.5% | 660 | $11K |
| 90686 | 1.4% | 1,032 | $11K | |
| 92551 | 1.1% | 4,273 | $9K | |
| 99354 | 1.1% | 123 | $9K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 74 | $7K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,344 | $6K |
| 90651 | <1% | 320 | $6K | |
| 90670 | <1% | 510 | $6K | |
| 99406 | <1% | 432 | $6K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 3,233 | $5K |
| 90480 | <1% | 141 | $4K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 187 | $4K |
| D1206 | Topical application of fluoride varnish | <1% | 160 | $4K |
| 97802 | <1% | 93 | $3K | |
| 90655 | <1% | 284 | $3K | |
| 90734 | <1% | 275 | $3K | |
| 99381 | <1% | 31 | $2K | |
| 86580 | <1% | 3,421 | $2K | |
| 91321 | <1% | 56 | $2K | |
| 90680 | <1% | 124 | $2K | |
| 90633 | <1% | 154 | $2K | |
| 90698 | <1% | 129 | $1K | |
| 90744 | <1% | 129 | $1K | |
| 90620 | <1% | 122 | $1K | |
| 91322 | <1% | 25 | $1K | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 58 | $874.50 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 4,878 | $874.41 |
| 91320 | <1% | 58 | $771.10 | |
| 99407 | <1% | 30 | $735.30 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 464 | $566.92 |
| 90710 | <1% | 40 | $447.48 | |
| 90649 | <1% | 14 | $293.91 | |
| 90685 | <1% | 26 | $285.05 | |
| 99383 | <1% | 12 | $275.32 | |
| 90700 | <1% | 26 | $265.67 | |
| 99382 | <1% | 14 | $184.63 | |
| 90707 | <1% | 14 | $154.98 | |
| 90648 | <1% | 14 | $148.34 | |
| 90713 | <1% | 13 | $133.53 | |
| 90716 | <1% | 13 | $132.84 | |
| 91319 | <1% | 17 | $65.84 | |
| 99401 | <1% | 460 | $23.22 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 169 | $4.01 |
| 90461 | 0% | 656 | $0.00 | |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 0% | 28 | $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 officialMARISTELA, OFELIA (CHIEF MEDICAL OFFICER)