Summersville Pediatrics INC.
Summersville Pediatrics INC. was paid $12.00M by Medicaid between Jan 2018 and Dec 2024, across 56 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 86% of everything it billed.
33Billing provider infoSUMMERSVILLE PEDIATRICS INC.
SUMMERSVILLE, WV 26651
SUMMERSVILLE, WV 26651
33aNPI1134197882assigned 03/09/2006
33bProvider typeSpecialist
28Total paid$12.00M
24GClaims333,182
24DCodes billed56
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in West Virginia
Rank by total paid#2 of 71
Median peer was paid$232K
This provider vs. median52×
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 | 52,181 | $2.32M | |
| 2019 | 31,675 | $1.29M | |
| 2020 | 41,047 | $1.23M | |
| 2021 | 49,266 | $1.67M | |
| 2022 | 58,681 | $1.93M | |
| 2023 | 52,908 | $1.80M | |
| 2024incomplete | 47,424 | $1.75M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 86% | 105,539 | 79,630 | $10.32M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.5% | 52,509 | 42,998 | $422K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.2% | 18,251 | 14,478 | $144K |
| 99051 | <1% | 16,909 | 14,998 | $114K | |
| 92551 | <1% | 15,678 | 15,012 | $102K | |
| 90686 | <1% | 5,713 | 5,480 | $82K | |
| 87430 | <1% | 7,183 | 6,573 | $63K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 7,542 | 7,196 | $56K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 7,827 | 7,527 | $55K |
| 87070 | <1% | 6,081 | 5,590 | $52K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 6,147 | 5,675 | $50K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 5,131 | 3,929 | $41K |
44 more codes
| 90670 | <1% | 4,271 | $39K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 7,250 | $32K |
| 90723 | <1% | 3,456 | $31K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,522 | $30K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 4,946 | $30K |
| 96160 | <1% | 6,484 | $28K | |
| 90647 | <1% | 3,480 | $28K | |
| 81003 | <1% | 3,219 | $27K | |
| 96127 | <1% | 6,446 | $25K | |
| 99401 | <1% | 934 | $24K | |
| 90633 | <1% | 2,720 | $22K | |
| 90681 | <1% | 2,086 | $18K | |
| 85018 | <1% | 2,567 | $17K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 1,094 | $16K |
| 36416 | <1% | 2,564 | $16K | |
| 90734 | <1% | 2,097 | $12K | |
| 90651 | <1% | 1,951 | $11K | |
| 95117 | <1% | 1,527 | $10K | |
| 90710 | <1% | 1,097 | $9K | |
| 99381 | <1% | 1,105 | $9K | |
| 90700 | <1% | 789 | $8K | |
| 87807 | <1% | 1,755 | $7K | |
| 90620 | <1% | 1,039 | $6K | |
| 90715 | <1% | 1,019 | $6K | |
| 90696 | <1% | 900 | $6K | |
| 90672 | <1% | 439 | $6K | |
| 90716 | <1% | 758 | $5K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 216 | $5K |
| 90707 | <1% | 737 | $5K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 623 | $2K |
| 90685 | <1% | 62 | $2K | |
| 90473 | <1% | 97 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 323 | $2K |
| 81025 | <1% | 122 | $571.36 | |
| 99383 | <1% | 26 | $562.75 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 189 | $362.66 |
| 88720 | <1% | 331 | $337.65 | |
| 81002 | <1% | 85 | $114.24 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 6,565 | $73.42 |
| 99384 | 0% | 12 | $0.00 | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 0% | 458 | $0.00 |
| 90671 | 0% | 280 | $0.00 | |
| 90380 | 0% | 13 | $0.00 | |
| 0071A | 0% | 18 | $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 officialMCCLUNG, JOYCE (OFFICE MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Summersville Pediatrics, INC. | Webster Springs, WV | $1.27M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.