Physician
Pediatric Specialists of Marion County PLLC
Pediatric Specialists of Marion County PLLC was paid $1.70M by Medicaid between Jan 2018 and Dec 2024, across 34 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 37% of everything it billed.
33Billing provider infoPEDIATRIC SPECIALISTS OF MARION COUNTY PLLC
SOUTH PITTSBURG, TN 37380
SOUTH PITTSBURG, TN 37380
33aNPI1154580736assigned 06/09/2008
33bProvider typePediatrics Physician
28Total paid$1.70M
24GClaims40,187
24DCodes billed34
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Tennessee
Rank by total paid#59 of 333
Median peer was paid$139K
This provider vs. median12×
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 | 5,068 | $201K | |
| 2019 | 5,450 | $215K | |
| 2020 | 4,394 | $180K | |
| 2021 | 5,779 | $262K | |
| 2022 | 6,979 | $307K | |
| 2023 | 6,465 | $275K | |
| 2024incomplete | 6,052 | $261K |
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 | 37% | 10,922 | 9,531 | $628K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 16% | 7,335 | 5,992 | $273K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 9.9% | 1,639 | 1,533 | $169K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 9.2% | 4,197 | 3,921 | $156K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.7% | 2,369 | 2,116 | $114K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.2% | 999 | 963 | $71K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.8% | 1,426 | 1,347 | $65K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.0% | 841 | 768 | $50K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 2.1% | 918 | 859 | $35K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.9% | 479 | 467 | $32K |
| 92583 | 1.8% | 1,158 | 1,031 | $30K | |
| 99177 | 1.5% | 2,711 | 2,470 | $26K |
22 more codes
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,216 | $13K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 684 | $9K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 108 | $7K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 381 | $5K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 129 | $4K |
| 36416 | <1% | 1,195 | $4K | |
| 83655 | <1% | 116 | $2K | |
| 92552 | <1% | 123 | $2K | |
| 96127 | <1% | 391 | $2K | |
| 96160 | <1% | 29 | $765.45 | |
| 90677 | <1% | 14 | $643.22 | |
| 87807 | <1% | 50 | $596.90 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 28 | $482.76 |
| 36415 | Collection of venous blood by venipuncture | <1% | 146 | $433.24 |
| 90670 | <1% | 205 | $263.68 | |
| 81003 | <1% | 74 | $165.57 | |
| 90686 | <1% | 141 | $64.83 | |
| 90647 | <1% | 44 | $33.77 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 28 | $1.20 |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | 0% | 14 | $0.00 |
| 90700 | 0% | 12 | $0.00 | |
| 90723 | 0% | 65 | $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 officialFOX, JOHN (PARTNER)
| Provider | Location | Paid |
|---|---|---|
| Colorectal Surgical & Gastroenterology Associates PSC | Lexington, KY | $92K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.