Physician
Rainbow Pediatrics, INC
Rainbow Pediatrics, INC was paid $7.43M by Medicaid between Jan 2018 and Dec 2024, across 55 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 39% of everything it billed.
33Billing provider infoRAINBOW PEDIATRICS, INC
BEAVER, WV 25813
BEAVER, WV 25813
33aNPI1215339098assigned 09/23/2014
33bProvider typePediatrics Physician
28Total paid$7.43M
24GClaims227,606
24DCodes billed55
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in West Virginia
Rank by total paid#2 of 57
Median peer was paid$409K
This provider vs. median18×
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 | 14,547 | $529K | |
| 2019 | 9,579 | $349K | |
| 2020 | 30,594 | $781K | |
| 2021 | 34,353 | $1.01M | |
| 2022 | 47,676 | $1.52M | |
| 2023 | 45,723 | $1.67M | |
| 2024incomplete | 45,134 | $1.57M |
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 | 39% | 52,335 | 42,789 | $2.90M |
| 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 | 11% | 10,370 | 9,641 | $839K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.1% | 9,532 | 9,151 | $678K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.6% | 8,806 | 8,381 | $564K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.6% | 4,739 | 4,608 | $344K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 3.9% | 11,720 | 11,247 | $287K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.8% | 6,563 | 5,980 | $279K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 3.7% | 9,247 | 8,149 | $272K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.9% | 16,561 | 15,845 | $219K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.1% | 10,092 | 8,987 | $154K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.7% | 1,534 | 1,497 | $125K |
| 99381 | 1.4% | 1,474 | 1,384 | $106K |
43 more codes
| 87634 | 1.2% | 1,534 | $92K | |
| 92551 | <1% | 7,722 | $74K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 4,970 | $73K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 6,507 | $70K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 5,875 | $55K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 595 | $44K |
| 83655 | <1% | 3,050 | $37K | |
| 99173 | <1% | 4,616 | $28K | |
| 90670 | <1% | 4,938 | $22K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 238 | $20K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 93 | $19K |
| 90648 | <1% | 7,127 | $18K | |
| 36416 | <1% | 4,275 | $15K | |
| 90723 | <1% | 5,507 | $14K | |
| 90633 | <1% | 3,399 | $8K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 229 | $8K |
| 90686 | <1% | 2,954 | $8K | |
| 90681 | <1% | 3,180 | $8K | |
| 90688 | <1% | 388 | $7K | |
| 87807 | <1% | 641 | $7K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 208 | $7K |
| 90710 | <1% | 3,058 | $6K | |
| 99177 | <1% | 2,007 | $6K | |
| 96127 | <1% | 1,719 | $5K | |
| 81003 | <1% | 1,260 | $3K | |
| 88720 | <1% | 1,144 | $3K | |
| 90671 | <1% | 2,303 | $3K | |
| 0001A | <1% | 51 | $1K | |
| 87631 | <1% | 28 | $1K | |
| 99051 | <1% | 470 | $1K | |
| 90700 | <1% | 1,379 | $902.57 | |
| 96380 | <1% | 44 | $668.34 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 28 | $373.64 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 48 | $331.81 |
| 90696 | <1% | 1,120 | $270.66 | |
| 90651 | <1% | 425 | $73.48 | |
| 90734 | <1% | 585 | $12.64 | |
| 0072A | <1% | 93 | $0.54 | |
| 0071A | <1% | 56 | $0.31 | |
| 91307 | <1% | 161 | $0.03 | |
| 90715 | <1% | 341 | $0.03 | |
| 90656 | 0% | 203 | $0.00 | |
| 91300 | 0% | 64 | $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 officialFERNALD, JOHN (PRESIDENT)