Physician
Wayzata Children's Clinic P.A.
Wayzata Children's Clinic P.A. was paid $2.01M by Medicaid between Jan 2018 and Dec 2024, across 42 billing codes. Its largest line is S0302, Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) — 22% of everything it billed.
33Billing provider infoWAYZATA CHILDREN'S CLINIC P.A.
MINNETONKA, MN 55305
MINNETONKA, MN 55305
33aNPI1023081577assigned 02/07/2006
33bProvider typePediatrics Physician
28Total paid$2.01M
24GClaims79,838
24DCodes billed42
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Minnesota
Rank by total paid#6 of 33
Median peer was paid$13K
This provider vs. median153×
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 | 16,995 | $160K | |
| 2019 | 18,687 | $463K | |
| 2020 | 12,649 | $403K | |
| 2021 | 15,963 | $532K | |
| 2022 | 8,975 | $265K | |
| 2023 | 3,604 | $95K | |
| 2024incomplete | 2,965 | $96K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 22% | 13,632 | 12,311 | $446K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 21% | 9,643 | 8,327 | $422K |
| 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 | 16% | 4,892 | 4,290 | $316K |
| X5622 | 12% | 5,493 | 4,885 | $241K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.1% | 2,516 | 2,314 | $143K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.3% | 1,620 | 1,402 | $87K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.7% | 1,393 | 1,307 | $75K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.7% | 7,224 | 6,500 | $74K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.3% | 3,537 | 3,181 | $46K |
| 99188 | 1.6% | 6,605 | 6,080 | $32K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.6% | 493 | 456 | $32K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1.1% | 955 | 870 | $22K |
30 more codes
| 92551 | 1.1% | 5,285 | $22K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 191 | $9K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,430 | $8K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 196 | $7K |
| 96127 | <1% | 1,410 | $6K | |
| 87430 | <1% | 784 | $6K | |
| 99173 | <1% | 5,358 | $5K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 120 | $4K |
| 0240U | <1% | 32 | $4K | |
| 87081 | <1% | 567 | $2K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 14 | $1K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 16 | $1K |
| 90686 | <1% | 2,542 | $995.94 | |
| 90474 | <1% | 142 | $878.39 | |
| 90473 | <1% | 69 | $875.91 | |
| T1013 | Sign language or oral interpretive services, per 15 minutes | <1% | 28 | $484.72 |
| 36416 | <1% | 133 | $319.31 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 115 | $285.02 |
| 90670 | <1% | 618 | $232.84 | |
| 90672 | <1% | 121 | $137.63 | |
| 94760 | <1% | 185 | $121.78 | |
| 90648 | <1% | 614 | $23.76 | |
| 90633 | <1% | 69 | $20.40 | |
| 96160 | <1% | 1,424 | $11.31 | |
| 90723 | 0% | 170 | $0.00 | |
| 90680 | 0% | 96 | $0.00 | |
| 90651 | 0% | 13 | $0.00 | |
| 91300 | 0% | 13 | $0.00 | |
| 87400 | 0% | 54 | $0.00 | |
| 90734 | 0% | 26 | $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 officialENGELBREKT, MARTHA (PRESIDENT)