Pediatric Partners of the Southwest

Pediatric Partners of the Southwest was paid $5.84M by Medicaid between Jan 2018 and Dec 2024, across 75 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 27% of everything it billed.

33Billing provider infoPEDIATRIC PARTNERS OF THE SOUTHWEST
DURANGO, CO 81301

33aNPI1083717219assigned 09/06/2006

33bProvider typePediatrics Physician

28Total paid$5.84M

24GClaims154,457

24DCodes billed75

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pediatrics Physician providers in Colorado

Rank by total paid#4 of 186

Median peer was paid$68K

This provider vs. median86×

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	21,052	$840K
2019	24,234	$975K
2020	21,822	$959K
2021	25,765	$1.08M
2022	24,321	$1.10M
2023	19,469	$607K
2024incomplete	17,794	$276K

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	27%	28,056	24,711	$1.56M
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%	7,954	7,080	$683K
90460	Immunization administration through 18 years of age via any route, first or only component	12%	21,049	19,386	$679K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	12%	8,582	7,754	$674K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	10%	7,081	6,602	$596K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	7.7%	5,582	4,988	$447K
96110	Developmental screening, with scoring and documentation, per standardized instrument	3.8%	14,583	13,496	$219K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	2.4%	1,630	1,504	$138K
G8510	Screening for depression is documented as negative, a follow-up plan is not required	1.7%	12,346	11,267	$100K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	1.3%	1,648	1,565	$79K
D0145	Oral evaluation for a patient under three years of age	1.3%	2,462	2,291	$73K
96127		1.1%	5,447	4,993	$64K

63 more codes

87502	Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets	1.1%	759	$63K
90837	Psychotherapy session, about an hour	<1%	631	$57K
90461		<1%	9,059	$46K
99215	Doctor's office visit, returning patient (complex)	<1%	492	$41K
90670		<1%	2,239	$34K
90832	Psychotherapy session, about 30 minutes	<1%	614	$32K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	1,453	$32K
T1017	Case management, billed per 15 minutes	<1%	2,044	$27K
D0190		<1%	1,848	$27K
87631		<1%	105	$13K
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	<1%	391	$12K
90686		<1%	5,099	$12K
90651		<1%	318	$11K
H0049	Alcohol and/or drug screening	<1%	1,358	$10K
0071A		<1%	210	$9K
99460		<1%	123	$8K
87634		<1%	126	$8K
0072A		<1%	127	$7K
92587		<1%	276	$7K
0001A		<1%	212	$6K
83655		<1%	491	$6K
90480		<1%	174	$5K
90698		<1%	657	$5K
0002A		<1%	108	$4K
99174		<1%	286	$4K
87811	Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19)	<1%	87	$3K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	126	$3K
G0315	Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)	<1%	124	$3K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	85	$3K
90671		<1%	270	$3K
Q3014	Telehealth originating site facility fee	<1%	162	$3K
90680		<1%	517	$3K
90834	Psychotherapy session, about 45 minutes	<1%	41	$3K
90697		<1%	209	$2K
99238	Hospital discharge day management, 30 minutes or less	<1%	38	$2K
36416		<1%	1,623	$2K
90833	Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on)	<1%	30	$2K
90633		<1%	228	$1K
99000		<1%	637	$1K
85018		<1%	459	$1K
90685		<1%	503	$1K
90734		<1%	65	$1K
99173		<1%	189	$1K
99050		<1%	138	$957.56
90672		<1%	196	$884.77
0081A		<1%	25	$824.78
91321		<1%	59	$770.40
90619		<1%	42	$704.47
90656		<1%	332	$506.32
90744		<1%	122	$340.60
90674		<1%	47	$295.61
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	25	$267.48
90715		<1%	45	$255.68
A4258	Spring-powered device for lancet, each	<1%	1,607	$231.28
90660		<1%	31	$89.65
98970		<1%	46	$75.00
96160		<1%	26	$72.84
99070		<1%	144	$72.12
81003		<1%	15	$25.87
91322		0%	12	$0.00
91300		0%	321	$0.00
99421		0%	12	$0.00
91307		0%	199	$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 officialFRALEY, MARTHA (PHYSICIAN ADMINISTRATOR/ CEO)