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SOUTHDALE PEDIATRIC ASSOCIATES, LTD
SOUTHDALE PEDIATRIC ASSOCIATES, LTD
NPI: 1245305895
· EDINA, MN 55435
· 261QM1300X
$5.35M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
48,188 |
$426K |
| 2019 |
47,962 |
$1.14M |
| 2020 |
42,516 |
$1.01M |
| 2021 |
39,229 |
$1.15M |
| 2022 |
18,491 |
$739K |
| 2023 |
11,512 |
$487K |
| 2024 |
9,928 |
$400K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
31,414 |
27,995 |
$1.60M |
| S0302 |
Completed epsdt |
26,177 |
23,797 |
$1.02M |
| X5622 |
|
11,189 |
9,703 |
$587K |
| 99392 |
|
5,576 |
5,129 |
$297K |
| 99214 |
|
4,422 |
4,123 |
$293K |
| 90460 |
|
13,711 |
12,328 |
$272K |
| 99391 |
|
5,526 |
4,790 |
$248K |
| 99393 |
|
4,205 |
3,917 |
$212K |
| 90461 |
|
7,337 |
6,573 |
$120K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,362 |
1,284 |
$98K |
| 99394 |
|
1,620 |
1,511 |
$95K |
| 87651 |
|
2,165 |
2,050 |
$71K |
| 90471 |
|
4,718 |
4,474 |
$51K |
| 92551 |
|
9,560 |
8,692 |
$43K |
| 99000 |
|
4,752 |
4,401 |
$38K |
| 99188 |
|
5,320 |
4,802 |
$38K |
| U0005 |
Infec agen detec ampli probe |
1,182 |
1,120 |
$29K |
| 87880 |
|
3,144 |
2,972 |
$29K |
| 87804 |
|
2,333 |
1,110 |
$27K |
| 95117 |
|
2,636 |
1,503 |
$17K |
| 87070 |
|
2,419 |
2,283 |
$13K |
| 99072 |
|
4,995 |
4,262 |
$13K |
| 83655 |
|
1,129 |
1,068 |
$12K |
| 90686 |
|
6,320 |
5,952 |
$11K |
| 96127 |
|
3,437 |
3,076 |
$11K |
| 36416 |
|
4,385 |
3,953 |
$11K |
| 95004 |
|
226 |
220 |
$9K |
| 96110 |
|
6,779 |
5,392 |
$8K |
| 99460 |
|
132 |
130 |
$8K |
| 99204 |
|
76 |
76 |
$8K |
| 99173 |
|
7,970 |
7,136 |
$7K |
| 85027 |
|
1,437 |
1,304 |
$7K |
| 99238 |
|
147 |
145 |
$7K |
| 99212 |
|
134 |
134 |
$5K |
| 85007 |
|
1,796 |
1,622 |
$5K |
| 36415 |
|
2,016 |
1,846 |
$5K |
| 85025 |
|
478 |
459 |
$4K |
| 85018 |
|
1,898 |
1,804 |
$4K |
| 71046 |
|
194 |
191 |
$3K |
| 80061 |
|
197 |
195 |
$2K |
| 90670 |
|
3,967 |
3,583 |
$2K |
| 96161 |
|
1,042 |
942 |
$1K |
| 90480 |
|
85 |
80 |
$1K |
| 90651 |
|
890 |
843 |
$1K |
| 90734 |
|
630 |
608 |
$1K |
| 99383 |
|
12 |
12 |
$946.20 |
| 90716 |
|
1,431 |
1,369 |
$664.17 |
| 81001 |
|
235 |
222 |
$663.25 |
| 94010 |
|
28 |
28 |
$483.65 |
| 90688 |
|
1,043 |
936 |
$434.80 |
| 90680 |
|
2,348 |
2,125 |
$406.12 |
| 90472 |
|
131 |
124 |
$388.27 |
| 90656 |
|
178 |
175 |
$358.60 |
| 90698 |
|
3,697 |
3,347 |
$322.42 |
| 99070 |
|
229 |
223 |
$316.64 |
| 90707 |
|
1,217 |
1,158 |
$311.00 |
| 87086 |
|
32 |
29 |
$257.24 |
| 0002A |
|
14 |
14 |
$247.76 |
| 90633 |
|
1,621 |
1,542 |
$240.47 |
| 0001A |
|
15 |
15 |
$209.70 |
| T1013 |
Sign lang/oral interpreter |
18 |
13 |
$165.73 |
| 91321 |
|
55 |
54 |
$148.63 |
| 90697 |
|
54 |
54 |
$134.02 |
| 99384 |
|
16 |
15 |
$114.88 |
| 90744 |
|
1,723 |
1,588 |
$114.30 |
| 90715 |
|
215 |
205 |
$66.43 |
| 90696 |
|
274 |
271 |
$63.41 |
| G2211 |
Complex e/m visit add on |
1,345 |
1,276 |
$56.04 |
| 82465 |
|
16 |
15 |
$5.68 |
| 90677 |
|
46 |
41 |
$0.04 |
| 90685 |
|
647 |
579 |
$0.00 |
| 91300 |
|
37 |
30 |
$0.00 |
| 90687 |
|
21 |
20 |
$0.00 |