Physician
Groden, Brian
Groden, Brian was paid $1.55M by Medicaid between Jan 2018 and Mar 2023, across 26 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.
33Billing provider infoGRODEN, BRIAN
NEW BEDFORD, MA 02740
NEW BEDFORD, MA 02740
33aNPI1215905443assigned 03/14/2006
33bProvider typePediatrics Physician
28Total paid$1.55M
24GClaims39,551
24DCodes billed26
24AFirst – last monthJan 2018 – Mar 2023
Compared with peers
Next to other Pediatrics Physician providers in Massachusetts
Rank by total paid#42 of 1,273
Median peer was paid$24K
This provider vs. median65×
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 | 7,656 | $362K | |
| 2019 | 8,804 | $332K | |
| 2020 | 8,246 | $283K | |
| 2021 | 6,512 | $231K | |
| 2022 | 6,636 | $268K | |
| 2023 | 1,697 | $71K |
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 | 24% | 5,990 | 5,478 | $366K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 16% | 5,372 | 5,162 | $245K |
| 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 | 12% | 1,817 | 1,739 | $178K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 11% | 1,901 | 1,901 | $163K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10% | 1,881 | 1,877 | $163K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 8.3% | 1,375 | 1,375 | $129K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.0% | 1,161 | 1,152 | $92K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 4.0% | 6,804 | 6,792 | $62K |
| 90461 | 3.8% | 2,079 | 2,071 | $59K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.9% | 2,810 | 2,803 | $29K |
| 96127 | 1.8% | 2,619 | 2,618 | $28K | |
| 36416 | <1% | 655 | 654 | $7K |
14 more codes
| 83655 | <1% | 552 | $6K | |
| 85018 | <1% | 2,304 | $5K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 298 | $4K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 135 | $3K |
| 90473 | <1% | 92 | $2K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 571 | $1K |
| 99442 | <1% | 56 | $1K | |
| 99000 | <1% | 973 | $973.00 | |
| 0071A | <1% | 18 | $825.84 | |
| 0001A | <1% | 15 | $688.20 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 18 | $618.30 |
| 99173 | <1% | 20 | $444.40 | |
| 99050 | <1% | 22 | $364.32 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 13 | $238.55 |
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.