Physician
Prospect Pediatrics PA
Prospect Pediatrics PA was paid $3.24M by Medicaid between Jan 2018 and Nov 2024, across 51 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 36% of everything it billed.
33Billing provider infoPROSPECT PEDIATRICS PA
BELLEVILLE, NJ 07109
BELLEVILLE, NJ 07109
33aNPI1023431871assigned 01/30/2014
33bProvider typePediatrics Physician
28Total paid$3.24M
24GClaims81,763
24DCodes billed51
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in New Jersey
Rank by total paid#44 of 549
Median peer was paid$154K
This provider vs. median21×
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 | 7,865 | $291K | |
| 2019 | 7,577 | $256K | |
| 2020 | 10,575 | $382K | |
| 2021 | 11,447 | $518K | |
| 2022 | 17,804 | $707K | |
| 2023 | 16,203 | $656K | |
| 2024incomplete | 10,292 | $432K |
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 | 36% | 18,767 | 16,532 | $1.18M |
| 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 | 12% | 4,431 | 4,346 | $382K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.9% | 3,058 | 2,996 | $288K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.9% | 2,728 | 2,687 | $255K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.0% | 2,288 | 2,231 | $196K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 5.7% | 7,145 | 6,929 | $184K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.5% | 1,647 | 1,609 | $177K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.2% | 1,800 | 1,729 | $71K |
| 99188 | 1.8% | 3,206 | 3,131 | $57K | |
| 90461 | 1.7% | 2,978 | 2,911 | $55K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.5% | 3,466 | 3,412 | $48K |
| 97802 | 1.3% | 1,587 | 1,578 | $41K |
39 more codes
| 36410 | 1.2% | 2,174 | $40K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,737 | $28K |
| 92587 | <1% | 1,022 | $26K | |
| 3008F | <1% | 1,287 | $24K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,999 | $23K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,723 | $20K |
| 36406 | <1% | 1,049 | $18K | |
| 99381 | <1% | 166 | $17K | |
| 90651 | <1% | 617 | $15K | |
| 83655 | <1% | 1,560 | $12K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,213 | $11K |
| 92552 | <1% | 537 | $8K | |
| 90734 | <1% | 505 | $8K | |
| 90686 | <1% | 2,364 | $7K | |
| 90620 | <1% | 225 | $7K | |
| 90670 | <1% | 1,070 | $7K | |
| 90716 | <1% | 702 | $7K | |
| 99173 | <1% | 2,329 | $4K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 48 | $4K |
| 90707 | <1% | 662 | $3K | |
| 90723 | <1% | 1,159 | $3K | |
| 0071A | <1% | 73 | $3K | |
| 0072A | <1% | 63 | $3K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $2K |
| 90633 | <1% | 696 | $2K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 163 | $2K |
| 90680 | <1% | 669 | $1K | |
| 90696 | <1% | 135 | $985.84 | |
| 90677 | <1% | 299 | $964.68 | |
| 90648 | <1% | 1,378 | $944.20 | |
| 90656 | <1% | 358 | $905.89 | |
| 90715 | <1% | 180 | $795.15 | |
| 69210 | <1% | 40 | $594.75 | |
| 90700 | <1% | 130 | $232.99 | |
| 92551 | <1% | 18 | $217.80 | |
| 96127 | <1% | 28 | $130.71 | |
| 90681 | <1% | 174 | $80.80 | |
| 91307 | <1% | 85 | $1.00 | |
| 90381 | 0% | 12 | $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 officialOKOH, FIDELIS (EXECUTIVE DIRECTOR OPERATIONS)