Physician
Cardinal Pediatrics PLLC
Cardinal Pediatrics PLLC was paid $1.98M by Medicaid between Nov 2019 and Dec 2024, across 72 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 28% of everything it billed.
33Billing provider infoCARDINAL PEDIATRICS PLLC
LOWELL, MA 01854
LOWELL, MA 01854
33aNPI1194372151assigned 08/23/2019
33bProvider typePediatrics Physician
28Total paid$1.98M
24GClaims94,592
24DCodes billed72
24AFirst – last monthNov 2019 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Massachusetts
Rank by total paid#21 of 1,273
Median peer was paid$24K
This provider vs. median82×
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 | |
|---|---|---|---|
| 2019 | 1,041 | $37K | |
| 2020 | 12,484 | $380K | |
| 2021 | 13,179 | $409K | |
| 2022 | 19,939 | $648K | |
| 2023 | 22,933 | $335K | |
| 2024incomplete | 25,016 | $168K |
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 | 28% | 13,105 | 11,863 | $550K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 8.5% | 6,475 | 6,088 | $168K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.7% | 2,763 | 2,760 | $153K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.0% | 2,486 | 2,372 | $138K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.5% | 2,338 | 2,333 | $129K |
| 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 | 6.1% | 4,210 | 4,031 | $120K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 5.4% | 11,522 | 11,058 | $106K |
| 92552 | 4.9% | 3,641 | 3,635 | $96K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.6% | 1,488 | 1,488 | $91K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 4.4% | 7,640 | 7,614 | $86K |
| 90461 | 3.2% | 1,687 | 1,653 | $64K | |
| 96127 | 2.6% | 4,564 | 4,446 | $52K |
60 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.0% | 2,889 | $40K |
| 92587 | 1.2% | 1,627 | $24K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.1% | 1,751 | $22K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.1% | 1,483 | $21K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 138 | $20K |
| 99177 | <1% | 3,765 | $17K | |
| 83655 | <1% | 1,480 | $16K | |
| S3005 | Performance measurement, evaluation of patient self assessment, depression | <1% | 744 | $7K |
| 99188 | <1% | 261 | $7K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 234 | $6K |
| 92015 | Determination of refractive state | <1% | 357 | $5K |
| 92551 | <1% | 483 | $5K | |
| 99051 | <1% | 564 | $4K | |
| 0071A | <1% | 82 | $4K | |
| 90621 | <1% | 58 | $3K | |
| 0072A | <1% | 74 | $3K | |
| 85018 | <1% | 1,534 | $3K | |
| 99381 | <1% | 38 | $3K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 107 | $3K |
| 90620 | <1% | 29 | $3K | |
| 99173 | <1% | 131 | $2K | |
| 90691 | <1% | 16 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 48 | $1K |
| 99441 | <1% | 121 | $1K | |
| 96160 | <1% | 4,491 | $632.19 | |
| 87807 | <1% | 34 | $392.70 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 14 | $184.17 |
| 96161 | <1% | 822 | $118.02 | |
| 81002 | <1% | 28 | $79.82 | |
| 90686 | <1% | 1,162 | $40.00 | |
| 90744 | 0% | 361 | $0.00 | |
| 36416 | 0% | 566 | $0.00 | |
| 90680 | 0% | 576 | $0.00 | |
| 90698 | 0% | 945 | $0.00 | |
| 90651 | 0% | 274 | $0.00 | |
| 90696 | 0% | 56 | $0.00 | |
| 90619 | 0% | 64 | $0.00 | |
| 90688 | 0% | 1,367 | $0.00 | |
| 90677 | 0% | 585 | $0.00 | |
| 90697 | 0% | 222 | $0.00 | |
| 99000 | 0% | 42 | $0.00 | |
| 91307 | 0% | 184 | $0.00 | |
| 90716 | 0% | 51 | $0.00 | |
| 90656 | 0% | 120 | $0.00 | |
| 94760 | 0% | 15 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 19 | $0.00 |
| 90674 | 0% | 17 | $0.00 | |
| 90633 | 0% | 605 | $0.00 | |
| 90734 | 0% | 202 | $0.00 | |
| 90661 | 0% | 253 | $0.00 | |
| 90670 | 0% | 935 | $0.00 | |
| 90681 | 0% | 173 | $0.00 | |
| 90710 | 0% | 101 | $0.00 | |
| 90649 | 0% | 115 | $0.00 | |
| 90715 | 0% | 41 | $0.00 | |
| 90707 | 0% | 56 | $0.00 | |
| 91311 | 0% | 34 | $0.00 | |
| G8447 | 0% | 75 | $0.00 | |
| 90671 | 0% | 16 | $0.00 | |
| 90685 | 0% | 38 | $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 officialARIAS, ELLYN (PRACTICE MANAGER)