Piedmont Pediatrics, PLC

Piedmont Pediatrics, PLC was paid $2.74M by Medicaid between Jan 2018 and Dec 2024, across 42 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.

33Billing provider infoPIEDMONT PEDIATRICS, PLC
WARRENTON, VA 20186

33aNPI1205802402assigned 02/27/2006

33bProvider typePediatrics Physician

28Total paid$2.74M

24GClaims71,129

24DCodes billed42

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pediatrics Physician providers in Virginia

Rank by total paid#66 of 817

Median peer was paid$29K

This provider vs. median94×

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	10,245	$406K
2019	13,105	$462K
2020	7,459	$302K
2021	7,658	$311K
2022	9,435	$405K
2023	11,745	$440K
2024incomplete	11,482	$417K

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	37%	17,423	16,499	$1.02M
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	31%	10,345	9,800	$845K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	7.1%	2,545	2,494	$195K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	5.8%	2,105	2,052	$158K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	4.0%	8,110	7,859	$109K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	3.1%	1,191	1,157	$86K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	3.1%	1,038	1,004	$84K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	1.6%	3,328	1,633	$45K
87811	Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19)	1.5%	1,139	1,129	$41K
90686		1.5%	3,424	3,366	$40K
99000		1.2%	11,200	10,627	$32K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	524	512	$20K

30 more codes

90670		<1%	638	$17K
90651		<1%	190	$6K
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	2,595	$6K
99177		<1%	1,392	$5K
92552		<1%	181	$5K
90656		<1%	245	$3K
90633		<1%	243	$3K
90698		<1%	198	$3K
36415	Collection of venous blood by venipuncture	<1%	905	$3K
90685		<1%	188	$2K
96127		<1%	413	$2K
90677		<1%	39	$2K
0001A		<1%	43	$2K
0002A		<1%	38	$2K
0072A		<1%	38	$1K
90707		<1%	68	$1K
90680		<1%	79	$1K
90734		<1%	56	$1K
0071A		<1%	26	$1K
90716		<1%	44	$911.81
90461		<1%	703	$910.03
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	<1%	76	$849.61
90619		<1%	30	$840.72
90744		<1%	67	$751.68
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	33	$553.29
90700		<1%	16	$203.42
85018		<1%	59	$156.06
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	12	$109.68
94760		<1%	60	$90.76
36416		<1%	82	$43.05

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 officialFITZWATER, BECKY (BUSINESS MANAGER)