Physician
Pediatric Associates of Madison,pc
Pediatric Associates of Madison,pc was paid $635K by Medicaid between Jan 2018 and Dec 2024, across 30 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.
33Billing provider infoPEDIATRIC ASSOCIATES OF MADISON,PC
MADISON, AL 35758
MADISON, AL 35758
33aNPI1083652036assigned 06/03/2006
33bProvider typePediatrics Physician
28Total paid$635K
24GClaims11,169
24DCodes billed30
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Alabama
Rank by total paid#105 of 199
Median peer was paid$702K
This provider vs. median0.9×
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 | 1,409 | $71K | |
| 2019 | 1,794 | $89K | |
| 2020 | 1,486 | $87K | |
| 2021 | 1,854 | $107K | |
| 2022 | 1,921 | $115K | |
| 2023 | 1,474 | $84K | |
| 2024incomplete | 1,231 | $82K |
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 | 46% | 3,603 | 3,159 | $289K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 15% | 1,378 | 1,356 | $94K |
| 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 | 10% | 519 | 478 | $67K |
| 90461 | 5.2% | 591 | 583 | $33K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.2% | 263 | 260 | $27K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 3.6% | 476 | 453 | $23K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.7% | 377 | 341 | $17K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.6% | 109 | 108 | $10K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.5% | 1,262 | 1,173 | $10K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.3% | 88 | 83 | $8K |
| 87634 | 1.1% | 157 | 146 | $7K | |
| 90686 | <1% | 318 | 316 | $6K |
18 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 564 | $6K |
| 90670 | <1% | 26 | $5K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 217 | $5K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 140 | $4K |
| 90677 | <1% | 13 | $4K | |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 15 | $3K |
| 87081 | <1% | 460 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 144 | $3K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 89 | $3K |
| 99177 | <1% | 182 | $3K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 24 | $3K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 53 | $1K |
| 87581 | <1% | 15 | $345.15 | |
| 90647 | <1% | 12 | $314.76 | |
| 90685 | <1% | 14 | $305.34 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 13 | $118.32 |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 0% | 32 | $0.00 |
| 99000 | 0% | 15 | $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 officialZBELL, TONYA (PRESIDENT)