Evergreen Pediatric Clinic PS

Evergreen Pediatric Clinic PS was paid $1.82M by Medicaid between Jan 2018 and Nov 2024, across 27 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 55% of everything it billed.

33Billing provider infoEVERGREEN PEDIATRIC CLINIC PS
VANCOUVER, WA 98664

33aNPI1144343773assigned 04/09/2007

33bProvider typePediatric Adolescent Medicine Physician

28Total paid$1.82M

24GClaims31,303

24DCodes billed27

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Pediatric Adolescent Medicine Physician providers in Washington

Rank by total paid#2 of 10

Median peer was paid$205K

This provider vs. median8.9×

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	5,180	$298K
2019	5,027	$295K
2020	3,028	$165K
2021	4,637	$196K
2022	5,044	$306K
2023	3,493	$282K
2024incomplete	4,894	$283K

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	55%	15,516	15,207	$1.00M
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	37%	7,511	7,250	$684K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.6%	521	518	$48K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	1.6%	326	326	$30K
90686		1.6%	2,283	2,271	$29K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	418	408	$9K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	54	54	$6K
90688		<1%	491	491	$5K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	<1%	45	41	$5K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	41	39	$3K
0072A		<1%	28	28	$1K
90480		<1%	29	25	$915.60

15 more codes

0071A		<1%	21	$810.00
90472	Immunization administration, each additional vaccine (list separately)	<1%	27	$599.60
90656		<1%	131	$393.40
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	26	$346.84
D9999	Unspecified adjunctive procedure, by report	<1%	12	$275.80
90707		<1%	15	$244.05
D0120	Dental checkup, returning patient	<1%	12	$235.68
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	<1%	15	$196.00
D1206	Topical application of fluoride varnish	<1%	12	$145.75
90685		<1%	14	$83.44
90651		<1%	13	$34.06
96160		<1%	14	$33.88
96161		<1%	13	$15.60
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)	<1%	1,056	$2.41
99072		0%	2,659	$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 officialBRYANT, TERI (OFFICE MANAGER)