Wellstar Kennestone Pediatric Associates, LLC

Wellstar Kennestone Pediatric Associates, LLC was paid $19K by Medicaid between Jan 2020 and Oct 2020, across 18 billing codes. Its largest line is 90460, Immunization administration through 18 years of age via any route, first or only component — 30% of everything it billed.

33Billing provider infoWELLSTAR KENNESTONE PEDIATRIC ASSOCIATES, LLC
MARIETTA, GA 30060

33aNPI1083660682assigned 05/25/2006

33bProvider typePediatrics Physician

28Total paid$19K

24GClaims704

24DCodes billed18

24AFirst – last monthJan 2020 – Oct 2020

Compared with peers

Next to other Pediatrics Physician providers in Georgia

Rank by total paid#133 of 220

Median peer was paid$57K

This provider vs. median0.3×

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
2020	704	$19K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90460	Immunization administration through 18 years of age via any route, first or only component	30%	132	131	$5K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	22%	36	36	$4K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	9.9%	18	18	$2K
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	9.2%	16	16	$2K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	7.6%	13	13	$1K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	6.2%	13	12	$1K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	5.8%	15	15	$1K
80061	Lipid panel	4.5%	56	45	$843.54
85018		1.4%	77	77	$255.36
96110	Developmental screening, with scoring and documentation, per standardized instrument	1.3%	15	15	$241.78
96160		<1%	51	51	$180.81
96127		<1%	37	37	$178.91

6 more codes

92551	<1%	13	$85.19
90686	<1%	65	$20.17
36416	<1%	109	$10.60
90651	0%	13	$0.00
99173	0%	12	$0.00
90670	0%	13	$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 officialASHE, NICOLE (EXECUTIVE DIRECTOR OF FINANCE)

Parent organizationWELLSTAR HEALTH SYSTEM, INC.

Same official

Other billing entities under ASHE, NICOLE

Full network →

Provider	Location	Paid
Wellstar Medical Group, LLC	Austell, GA	$5K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.