Clinic
Kidzcare Pediatrics, PLLC
Kidzcare Pediatrics, PLLC was paid $458K by Medicaid between Jan 2018 and Dec 2021, across 26 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 57% of everything it billed.
33Billing provider infoKIDZCARE PEDIATRICS, PLLC
MADISONVILLE, TN 37354
MADISONVILLE, TN 37354
33aNPI1215471198assigned 12/12/2016
33bProvider typeRural Health Clinic/Center
28Total paid$458K
24GClaims17,251
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2021
Compared with peers
Next to other Rural Health Clinic/Center providers in Tennessee
Rank by total paid#27 of 96
Median peer was paid$127K
This provider vs. median3.6×
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 | 5,707 | $148K | |
| 2019 | 6,371 | $170K | |
| 2020 | 3,778 | $103K | |
| 2021 | 1,395 | $37K |
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 | 57% | 6,788 | 5,877 | $262K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 9.5% | 2,179 | 861 | $43K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 9.5% | 1,416 | 1,113 | $43K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.6% | 459 | 425 | $30K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.7% | 368 | 344 | $22K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.8% | 185 | 183 | $13K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.2% | 765 | 566 | $10K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.1% | 881 | 837 | $10K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.7% | 918 | 806 | $8K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.1% | 186 | 177 | $5K |
| 99177 | 1.0% | 708 | 678 | $5K | |
| 92558 | <1% | 565 | 543 | $3K |
14 more codes
| 81002 | <1% | 486 | $1K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 63 | $932.91 |
| 85018 | <1% | 353 | $776.62 | |
| 81003 | <1% | 275 | $516.62 | |
| 83655 | <1% | 21 | $302.25 | |
| 86318 | <1% | 16 | $289.75 | |
| 90648 | 0% | 221 | $0.00 | |
| 90670 | 0% | 219 | $0.00 | |
| 90707 | 0% | 29 | $0.00 | |
| 90633 | 0% | 28 | $0.00 | |
| 90681 | 0% | 12 | $0.00 | |
| 90723 | 0% | 59 | $0.00 | |
| 90686 | 0% | 36 | $0.00 | |
| 90716 | 0% | 15 | $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 officialGOPINATHAN, SAJI (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Kidzcare Pediatrics, PLLC | Athens, TN | $12.52M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.