Physician
East Elm Pediatrics
East Elm Pediatrics was paid $2.74M by Medicaid between Jan 2018 and Oct 2024, across 66 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 23% of everything it billed.
33Billing provider infoEAST ELM PEDIATRICS
PITTSFIELD, MA 01201
PITTSFIELD, MA 01201
33aNPI1215296777assigned 05/03/2012
33bProvider typePediatric Adolescent Medicine Physician
28Total paid$2.74M
24GClaims108,624
24DCodes billed66
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Pediatric Adolescent Medicine Physician providers in Massachusetts
Rank by total paid#3 of 54
Median peer was paid$119K
This provider vs. median23×
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 | 15,777 | $430K | |
| 2019 | 14,568 | $397K | |
| 2020 | 12,150 | $311K | |
| 2021 | 22,552 | $492K | |
| 2022 | 20,386 | $432K | |
| 2023 | 15,285 | $427K | |
| 2024incomplete | 7,906 | $256K |
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 | 23% | 10,528 | 9,486 | $642K |
| 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 | 19% | 6,137 | 5,564 | $524K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.1% | 2,313 | 2,285 | $194K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.3% | 6,874 | 6,626 | $173K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.0% | 2,019 | 1,993 | $164K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.9% | 1,665 | 1,617 | $134K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.3% | 1,352 | 1,329 | $118K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 4.2% | 13,123 | 9,127 | $114K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.6% | 2,334 | 2,237 | $98K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.4% | 801 | 746 | $94K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 2.8% | 8,560 | 8,197 | $78K |
| 99051 | 2.8% | 5,116 | 4,728 | $78K |
54 more codes
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.6% | 1,363 | $45K |
| 92552 | 1.3% | 1,481 | $36K | |
| 99173 | 1.3% | 2,985 | $35K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.1% | 1,254 | $30K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 828 | $23K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,688 | $20K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,057 | $20K |
| 90461 | <1% | 1,898 | $20K | |
| 92567 | <1% | 1,760 | $20K | |
| 99188 | <1% | 691 | $18K | |
| 96127 | <1% | 1,501 | $12K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 779 | $10K |
| 83655 | <1% | 1,047 | $10K | |
| 94760 | <1% | 7,018 | $9K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 55 | $5K |
| 0072A | <1% | 119 | $5K | |
| 0071A | <1% | 107 | $4K | |
| 87428 | <1% | 106 | $4K | |
| 99423 | <1% | 16 | $1K | |
| 99460 | <1% | 12 | $1K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 78 | $954.48 |
| 81002 | <1% | 347 | $867.77 | |
| 0002A | <1% | 16 | $688.05 | |
| 0001A | <1% | 15 | $688.05 | |
| 82465 | <1% | 168 | $598.03 | |
| 85018 | <1% | 235 | $496.75 | |
| 87807 | <1% | 37 | $419.39 | |
| 94761 | <1% | 61 | $183.14 | |
| 96161 | <1% | 96 | $49.22 | |
| 96160 | <1% | 37 | $42.79 | |
| D1206 | Topical application of fluoride varnish | <1% | 183 | $28.60 |
| 99058 | <1% | 64 | $13.59 | |
| 99070 | <1% | 319 | $10.77 | |
| 99000 | <1% | 553 | $5.50 | |
| 90677 | <1% | 109 | $0.22 | |
| 90633 | 0% | 403 | $0.00 | |
| 90700 | 0% | 12 | $0.00 | |
| 90670 | 0% | 807 | $0.00 | |
| 99072 | 0% | 10,883 | $0.00 | |
| 90710 | 0% | 170 | $0.00 | |
| 90685 | 0% | 74 | $0.00 | |
| 90734 | 0% | 305 | $0.00 | |
| 90671 | 0% | 59 | $0.00 | |
| 90672 | 0% | 22 | $0.00 | |
| 90648 | 0% | 13 | $0.00 | |
| 90715 | 0% | 42 | $0.00 | |
| 90686 | 0% | 3,304 | $0.00 | |
| 90698 | 0% | 582 | $0.00 | |
| 36416 | 0% | 1,921 | $0.00 | |
| 90744 | 0% | 219 | $0.00 | |
| 90651 | 0% | 223 | $0.00 | |
| 90680 | 0% | 484 | $0.00 | |
| 90688 | 0% | 14 | $0.00 | |
| 91307 | 0% | 182 | $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 officialDALLENBACH, JOHN (OWNER)