Physician
Walton Pediatrics and Medical Associates, INC
Walton Pediatrics and Medical Associates, INC was paid $3.50M by Medicaid between Jan 2018 and Nov 2024, across 95 billing codes. Its largest line is 99391, Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) — 14% of everything it billed.
33Billing provider infoWALTON PEDIATRICS AND MEDICAL ASSOCIATES, INC
SACRAMENTO, CA 95823
SACRAMENTO, CA 95823
33aNPI1144271834assigned 05/15/2006
33bProvider typePediatrics Physician
28Total paid$3.50M
24GClaims483,159
24DCodes billed95
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in California
Rank by total paid#44 of 1,490
Median peer was paid$15K
This provider vs. median234×
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 | 95,739 | $783K | |
| 2019 | 131,069 | $554K | |
| 2020 | 96,078 | $444K | |
| 2021 | 39,009 | $478K | |
| 2022 | 39,677 | $377K | |
| 2023 | 42,849 | $447K | |
| 2024incomplete | 38,738 | $420K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 14% | 9,517 | 9,302 | $494K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 13% | 28,989 | 27,743 | $439K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 11% | 9,987 | 9,576 | $375K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10% | 11,406 | 11,216 | $351K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 7.5% | 6,634 | 6,435 | $264K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 7.5% | 40,597 | 38,660 | $263K |
| 99381 | 5.3% | 2,679 | 2,616 | $185K | |
| G9920 | Screening performed and negative | 4.3% | 14,787 | 14,690 | $150K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 3.1% | 1,810 | 1,796 | $108K |
| 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 | 2.4% | 5,060 | 4,975 | $83K |
| 97803 | 2.2% | 35,265 | 34,518 | $77K | |
| 99383 | 1.6% | 1,184 | 1,094 | $56K |
83 more codes
| 99203 | Doctor's office visit, new patient (routine) | 1.4% | 1,028 | $48K |
| 92551 | 1.3% | 24,987 | $46K | |
| 97802 | 1.0% | 5,378 | $36K | |
| 99384 | 1.0% | 673 | $36K | |
| 99382 | <1% | 625 | $29K | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 21,942 | $28K |
| 90670 | <1% | 9,034 | $28K | |
| 90680 | <1% | 5,891 | $24K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 3,339 | $23K |
| 99188 | <1% | 12,570 | $20K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 4,169 | $19K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 623 | $19K |
| 90686 | <1% | 7,800 | $18K | |
| 90697 | <1% | 3,314 | $17K | |
| 90651 | <1% | 5,068 | $16K | |
| 85018 | <1% | 31,020 | $15K | |
| D1206 | Topical application of fluoride varnish | <1% | 1,000 | $14K |
| 90698 | <1% | 5,131 | $14K | |
| 0071A | <1% | 307 | $12K | |
| 90744 | <1% | 3,258 | $11K | |
| 0072A | <1% | 275 | $11K | |
| 99173 | <1% | 19,888 | $11K | |
| 90620 | <1% | 2,213 | $10K | |
| 90671 | <1% | 1,842 | $10K | |
| 90633 | <1% | 5,231 | $9K | |
| 90648 | <1% | 2,421 | $8K | |
| 86580 | <1% | 7,593 | $8K | |
| 96127 | <1% | 8,340 | $8K | |
| 99460 | <1% | 181 | $8K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 594 | $8K |
| 90681 | <1% | 899 | $7K | |
| D0120 | Dental checkup, returning patient | <1% | 34,399 | $6K |
| 81000 | <1% | 18,930 | $6K | |
| 99401 | <1% | 29,045 | $6K | |
| 90723 | <1% | 1,368 | $6K | |
| 90715 | <1% | 2,482 | $5K | |
| G9919 | Screening performed and positive and provision of recommendations | <1% | 515 | $5K |
| 90696 | <1% | 2,384 | $4K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 178 | $4K |
| 90707 | <1% | 2,593 | $4K | |
| 90716 | <1% | 2,690 | $4K | |
| 90685 | <1% | 2,096 | $3K | |
| 90710 | <1% | 2,533 | $3K | |
| 90619 | <1% | 943 | $3K | |
| 90700 | <1% | 1,392 | $3K | |
| 0001A | <1% | 71 | $3K | |
| 90734 | <1% | 2,771 | $3K | |
| 0002A | <1% | 63 | $3K | |
| 87110 | <1% | 2,957 | $2K | |
| 81002 | <1% | 747 | $1K | |
| 99000 | <1% | 310 | $1K | |
| 80061 | Lipid panel | <1% | 1,114 | $1K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 872 | $893.96 |
| 0081A | <1% | 21 | $840.00 | |
| 0003A | <1% | 17 | $670.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 39 | $668.40 |
| 90656 | <1% | 367 | $626.30 | |
| 0073A | <1% | 13 | $520.00 | |
| 94760 | <1% | 2,145 | $467.26 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 191 | $266.25 |
| 92081 | <1% | 2,605 | $172.13 | |
| 96156 | <1% | 137 | $162.05 | |
| 90380 | <1% | 20 | $144.00 | |
| 69210 | <1% | 70 | $94.36 | |
| 99385 | <1% | 12 | $91.77 | |
| 90381 | <1% | 15 | $81.00 | |
| 90621 | <1% | 95 | $59.04 | |
| 90713 | <1% | 30 | $55.08 | |
| 99442 | <1% | 24 | $26.97 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 31 | $18.71 |
| 96160 | <1% | 628 | $17.61 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 17 | $17.50 |
| 80053 | Comprehensive metabolic panel | <1% | 26 | $16.54 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 24 | $11.69 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 24 | $6.76 |
| 82947 | <1% | 23 | $5.22 | |
| 36416 | <1% | 1,289 | $4.03 | |
| 83540 | 0% | 21 | $0.00 | |
| 3078F | 0% | 35 | $0.00 | |
| A7015 | Aerosol mask, used with dme nebulizer | 0% | 127 | $0.00 |
| 82728 | 0% | 22 | $0.00 | |
| 3074F | 0% | 36 | $0.00 | |
| 99441 | 0% | 53 | $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 officialWALTON, STEPHANIE (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Sacramento Pediatrics Medical Group | Sacramento, CA | $196K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.