Physician
Metrowest Pediatrics PC
Metrowest Pediatrics PC was paid $99K by Medicaid between Jan 2018 and Nov 2021, across 16 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 58% of everything it billed.
33Billing provider infoMETROWEST PEDIATRICS PC
FRAMINGHAM, MA 01701
FRAMINGHAM, MA 01701
33aNPI1245264456assigned 07/11/2006
33bProvider typePediatrics Physician
28Total paid$99K
24GClaims3,063
24DCodes billed16
24AFirst – last monthJan 2018 – Nov 2021
Compared with peers
Next to other Pediatrics Physician providers in Massachusetts
Rank by total paid#406 of 1,273
Median peer was paid$24K
This provider vs. median4.1×
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 | 1,321 | $41K | |
| 2019 | 1,002 | $36K | |
| 2020 | 473 | $12K | |
| 2021 | 267 | $11K |
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 | 58% | 842 | 800 | $58K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 23% | 829 | 655 | $23K |
| 99173 | 4.7% | 233 | 206 | $5K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.8% | 48 | 42 | $4K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.1% | 512 | 428 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.5% | 24 | 24 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.8% | 84 | 84 | $2K |
| 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 | 1.2% | 12 | 12 | $1K |
| 96127 | <1% | 68 | 68 | $704.88 | |
| 90461 | <1% | 16 | 14 | $611.35 | |
| 99442 | <1% | 12 | 12 | $255.19 | |
| 99441 | <1% | 14 | 13 | $155.45 |
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 officialGAINES, RAISA (PRESIDENT)