Physician
Medical Center for Children & Adolescents, PA
Medical Center for Children & Adolescents, PA was paid $8.76M by Medicaid between Jan 2018 and Dec 2024, across 65 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 44% of everything it billed.
33Billing provider infoMEDICAL CENTER FOR CHILDREN & ADOLESCENTS, PA
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
33aNPI1073528998assigned 07/29/2006
33bProvider typePediatrics Physician
28Total paid$8.76M
24GClaims183,903
24DCodes billed65
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Idaho
Rank by total paid#4 of 22
Median peer was paid$564K
This provider vs. median16×
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 | 31,906 | $1.35M | |
| 2019 | 32,283 | $1.42M | |
| 2020 | 24,718 | $1.16M | |
| 2021 | 26,606 | $1.31M | |
| 2022 | 27,094 | $1.41M | |
| 2023 | 21,451 | $1.18M | |
| 2024incomplete | 19,845 | $940K |
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 | 44% | 54,948 | 53,470 | $3.83M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 11% | 9,781 | 9,776 | $994K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 11% | 10,912 | 10,410 | $967K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.3% | 10,303 | 10,285 | $552K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.2% | 5,443 | 5,441 | $546K |
| 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 | 4.0% | 3,374 | 3,298 | $351K |
| 90461 | 2.8% | 8,056 | 7,409 | $243K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.3% | 11,218 | 11,204 | $204K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.2% | 1,699 | 1,698 | $190K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 2.0% | 4,973 | 4,939 | $172K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.9% | 1,840 | 1,833 | $167K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.7% | 3,628 | 3,550 | $153K |
53 more codes
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.1% | 4,406 | $93K |
| 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% | 2,852 | $45K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 617 | $39K |
| 90473 | <1% | 2,204 | $38K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,603 | $37K |
| 99173 | <1% | 728 | $19K | |
| 99460 | <1% | 220 | $18K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 1,761 | $18K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 420 | $18K |
| 36416 | <1% | 5,641 | $17K | |
| 87631 | <1% | 119 | $15K | |
| 87081 | <1% | 1,563 | $11K | |
| 96127 | <1% | 1,584 | $7K | |
| 83655 | <1% | 229 | $3K | |
| 92551 | <1% | 203 | $3K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 362 | $3K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 363 | $2K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 32 | $1K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 12 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 81 | $947.35 |
| 99462 | <1% | 16 | $619.36 | |
| 90686 | <1% | 8,489 | $476.02 | |
| 85014 | <1% | 136 | $359.59 | |
| 85018 | <1% | 136 | $359.59 | |
| 81000 | <1% | 98 | $347.64 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 25 | $326.49 |
| A7010 | Corrugated tubing, disposable, used with large volume nebulizer, 100 feet | <1% | 68 | $319.99 |
| 36415 | Collection of venous blood by venipuncture | <1% | 24 | $122.22 |
| 80053 | Comprehensive metabolic panel | <1% | 12 | $114.00 |
| A7015 | Aerosol mask, used with dme nebulizer | <1% | 68 | $105.74 |
| J8540 | Dexamethasone, oral, 0.25 mg | <1% | 347 | $74.53 |
| 90672 | <1% | 1,607 | $45.75 | |
| 90670 | <1% | 5,943 | $7.67 | |
| 90633 | <1% | 1,190 | $7.55 | |
| 90734 | <1% | 126 | $1.61 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 24 | $0.94 |
| 90723 | <1% | 4,008 | $0.11 | |
| 90647 | <1% | 3,865 | $0.10 | |
| 90680 | <1% | 3,274 | $0.08 | |
| 90677 | <1% | 878 | $0.02 | |
| 84030 | <1% | 12 | $0.01 | |
| 90715 | 0% | 80 | $0.00 | |
| 90710 | 0% | 80 | $0.00 | |
| 90707 | 0% | 54 | $0.00 | |
| 90700 | 0% | 28 | $0.00 | |
| 90656 | 0% | 383 | $0.00 | |
| 90660 | 0% | 145 | $0.00 | |
| 90651 | 0% | 324 | $0.00 | |
| 90619 | 0% | 102 | $0.00 | |
| 90696 | 0% | 68 | $0.00 | |
| 90688 | 0% | 52 | $0.00 | |
| 90716 | 0% | 54 | $0.00 | |
| 91307 | 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 officialPANKAU, MICHAEL (PRESIDENT)