Physician
Pioneer Pediatrics, PLLC
Pioneer Pediatrics, PLLC was paid $6.30M by Medicaid between Jan 2018 and Dec 2024, across 51 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 19% of everything it billed.
33Billing provider infoPIONEER PEDIATRICS, PLLC
MCMINNVILLE, TN 37110
MCMINNVILLE, TN 37110
33aNPI1184816720assigned 08/17/2007
33bProvider typePediatrics Physician
28Total paid$6.30M
24GClaims222,240
24DCodes billed51
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Tennessee
Rank by total paid#16 of 333
Median peer was paid$139K
This provider vs. median45×
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 | 26,454 | $715K | |
| 2019 | 33,023 | $865K | |
| 2020 | 27,695 | $773K | |
| 2021 | 34,096 | $1000K | |
| 2022 | 37,182 | $1.05M | |
| 2023 | 33,788 | $992K | |
| 2024incomplete | 30,002 | $900K |
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 | 19% | 30,863 | 28,022 | $1.17M |
| 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 | 17% | 18,283 | 16,290 | $1.04M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 12% | 15,691 | 13,868 | $730K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 11% | 12,268 | 10,666 | $715K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.8% | 9,371 | 8,795 | $617K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 8.7% | 22,825 | 18,032 | $550K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.6% | 4,589 | 4,341 | $293K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 4.1% | 7,844 | 7,078 | $258K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.1% | 7,942 | 7,236 | $196K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.9% | 17,163 | 7,454 | $183K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.8% | 1,652 | 1,564 | $112K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.6% | 12,368 | 10,968 | $101K |
39 more codes
| 87428 | 1.2% | 1,469 | $74K | |
| 99177 | <1% | 12,511 | $60K | |
| 87400 | <1% | 3,615 | $32K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 590 | $29K |
| 87430 | <1% | 3,381 | $28K | |
| 99460 | <1% | 363 | $18K | |
| 96161 | <1% | 1,649 | $17K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,424 | $17K |
| 87807 | <1% | 2,027 | $16K | |
| 83655 | <1% | 768 | $7K | |
| 90670 | <1% | 6,524 | $7K | |
| 87420 | <1% | 445 | $4K | |
| 90461 | <1% | 8,292 | $3K | |
| 96127 | <1% | 674 | $2K | |
| 90677 | <1% | 859 | $2K | |
| 36416 | <1% | 2,083 | $2K | |
| 90734 | <1% | 243 | $2K | |
| 90716 | <1% | 1,146 | $2K | |
| 90723 | <1% | 4,418 | $2K | |
| 99381 | <1% | 28 | $2K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 38 | $1K |
| 90686 | <1% | 1,950 | $1K | |
| 90707 | <1% | 1,144 | $1K | |
| 85018 | <1% | 473 | $852.67 | |
| 90681 | <1% | 1,238 | $838.32 | |
| 81003 | <1% | 367 | $567.26 | |
| 90633 | <1% | 1,501 | $455.39 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 25 | $380.37 |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 12 | $289.45 |
| 90647 | <1% | 1,494 | $201.42 | |
| 90656 | <1% | 146 | $75.17 | |
| 99173 | <1% | 13 | $73.98 | |
| 90651 | 0% | 65 | $0.00 | |
| 90698 | 0% | 153 | $0.00 | |
| 90696 | 0% | 117 | $0.00 | |
| 94760 | 0% | 14 | $0.00 | |
| 90744 | 0% | 32 | $0.00 | |
| 90685 | 0% | 61 | $0.00 | |
| 90715 | 0% | 29 | $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 officialHARPER, MELINDA (PARTNER)