Physician
Ethel and Raphael Pediatrics
Ethel and Raphael Pediatrics was paid $506K by Medicaid between Jan 2018 and Oct 2023, across 21 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 36% of everything it billed.
33Billing provider infoETHEL AND RAPHAEL PEDIATRICS
OCEAN, NJ 07712
OCEAN, NJ 07712
33aNPI1124282330assigned 07/16/2008
33bProvider typePediatrics Physician
28Total paid$506K
24GClaims19,243
24DCodes billed21
24AFirst – last monthJan 2018 – Oct 2023
Compared with peers
Next to other Pediatrics Physician providers in New Jersey
Rank by total paid#176 of 549
Median peer was paid$154K
This provider vs. median3.3×
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 | |
|---|---|---|---|
| 2018 | 2,343 | $112K | |
| 2019 | 2,838 | $112K | |
| 2020 | 2,074 | $60K | |
| 2021 | 4,119 | $89K | |
| 2022 | 5,322 | $95K | |
| 2023 | 2,547 | $37K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 36% | 3,194 | 2,793 | $182K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 2,359 | 2,059 | $82K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 16% | 2,544 | 2,083 | $79K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.8% | 760 | 708 | $34K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.1% | 723 | 621 | $31K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 4.2% | 2,170 | 1,726 | $21K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.1% | 3,363 | 2,796 | $21K |
| 99242 | 2.5% | 275 | 262 | $13K | |
| 99243 | 2.4% | 325 | 309 | $12K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.0% | 261 | 213 | $10K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.9% | 228 | 196 | $10K |
| 92567 | 1.1% | 916 | 790 | $6K |
9 more codes
| 90461 | <1% | 577 | $3K | |
| 90658 | <1% | 113 | $1K | |
| 90686 | <1% | 34 | $572.57 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 14 | $560.00 |
| H0033 | Oral medication administration, direct observation | <1% | 1,017 | $173.25 |
| 90744 | <1% | 27 | $27.36 | |
| 99000 | <1% | 75 | $7.14 | |
| G8711 | Prescribed antibiotic on or within 3 days after the episode date | 0% | 27 | $0.00 |
| 99173 | 0% | 241 | $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 officialOMOTOSO, OLUKEMI (OWNER)