Physician
Royal Oak Pediatric Associates, INC
Royal Oak Pediatric Associates, INC was paid $5.19M by Medicaid between Jan 2018 and Dec 2024, across 65 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 56% of everything it billed.
33Billing provider infoROYAL OAK PEDIATRIC ASSOCIATES, INC
MARION, VA 24354
MARION, VA 24354
33aNPI1114295110assigned 12/05/2011
33bProvider typePediatrics Physician
28Total paid$5.19M
24GClaims190,122
24DCodes billed65
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Virginia
Rank by total paid#30 of 817
Median peer was paid$29K
This provider vs. median177×
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 | 8,896 | $210K | |
| 2019 | 29,488 | $702K | |
| 2020 | 27,338 | $664K | |
| 2021 | 30,027 | $769K | |
| 2022 | 38,162 | $1.01M | |
| 2023 | 35,456 | $983K | |
| 2024incomplete | 20,755 | $849K |
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 | 56% | 52,725 | 42,835 | $2.88M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.9% | 6,028 | 5,324 | $411K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.7% | 5,978 | 5,041 | $401K |
| 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 | 5.0% | 3,392 | 2,844 | $259K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.8% | 2,198 | 1,920 | $145K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.9% | 3,554 | 2,844 | $99K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.8% | 11,866 | 10,636 | $92K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.7% | 7,523 | 3,245 | $88K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.6% | 1,328 | 1,007 | $82K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.5% | 6,528 | 5,665 | $77K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 1.4% | 2,327 | 1,972 | $72K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.2% | 872 | 742 | $62K |
53 more codes
| 90670 | 1.2% | 3,145 | $61K | |
| 92551 | 1.0% | 6,182 | $52K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 1,674 | $51K |
| 99188 | <1% | 2,175 | $43K | |
| 90686 | <1% | 3,254 | $34K | |
| 99177 | <1% | 8,563 | $31K | |
| 90723 | <1% | 2,071 | $28K | |
| 87634 | <1% | 646 | $24K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 3,137 | $21K |
| 90648 | <1% | 1,883 | $19K | |
| 87807 | <1% | 1,326 | $14K | |
| 90633 | <1% | 1,072 | $12K | |
| 99173 | <1% | 5,278 | $11K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 10,175 | $11K |
| 90681 | <1% | 638 | $10K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 654 | $8K |
| 90651 | <1% | 233 | $8K | |
| 85018 | <1% | 3,697 | $7K | |
| 90647 | <1% | 761 | $7K | |
| 87081 | <1% | 1,138 | $7K | |
| 83655 | <1% | 680 | $6K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 799 | $6K |
| 90461 | <1% | 5,824 | $6K | |
| 99000 | <1% | 5,986 | $6K | |
| 99381 | <1% | 62 | $4K | |
| 90710 | <1% | 126 | $4K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 102 | $3K |
| 81003 | <1% | 1,474 | $3K | |
| 99051 | <1% | 1,067 | $2K | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 110 | $2K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 119 | $2K |
| 87428 | <1% | 86 | $2K | |
| 90696 | <1% | 108 | $2K | |
| 36416 | <1% | 7,512 | $2K | |
| 96127 | <1% | 310 | $2K | |
| 90734 | <1% | 109 | $2K | |
| 80061 | Lipid panel | <1% | 127 | $1K |
| 94760 | <1% | 2,332 | $1K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 485 | $1K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 13 | $850.82 |
| 96161 | <1% | 371 | $671.46 | |
| 90707 | <1% | 40 | $525.53 | |
| 90716 | <1% | 28 | $376.67 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 15 | $197.88 |
| 90700 | <1% | 13 | $154.78 | |
| 86308 | <1% | 33 | $127.58 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 15 | $37.60 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 22 | $29.19 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 56 | $3.62 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 23 | $0.34 |
| 36591 | 0% | 27 | $0.00 | |
| 94762 | 0% | 15 | $0.00 | |
| 91300 | 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 officialHENLEY, ANITA (OWNER)