Physician
Arcenas, Elaine
Arcenas, Elaine was paid $4.06M by Medicaid between Jan 2018 and Dec 2024, across 60 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
33Billing provider infoARCENAS, ELAINE
BAY SHORE, NY 11706
BAY SHORE, NY 11706
33aNPI1245315456assigned 10/26/2006
33bProvider typePediatric Adolescent Medicine Physician
28Total paid$4.06M
24GClaims128,826
24DCodes billed60
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Adolescent Medicine Physician providers in New York
Rank by total paid#13 of 161
Median peer was paid$100K
This provider vs. median40×
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 | 13,868 | $435K | |
| 2019 | 20,621 | $574K | |
| 2020 | 22,118 | $475K | |
| 2021 | 19,769 | $532K | |
| 2022 | 17,204 | $636K | |
| 2023 | 19,900 | $824K | |
| 2024incomplete | 15,346 | $585K |
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 | 35% | 22,919 | 20,581 | $1.42M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 9.8% | 14,075 | 12,947 | $398K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 8.5% | 5,059 | 5,037 | $347K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.3% | 4,896 | 4,875 | $296K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.7% | 4,195 | 4,166 | $271K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.9% | 4,000 | 3,690 | $238K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 5.3% | 14,278 | 14,025 | $214K |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 5.2% | 2,364 | 2,361 | $211K |
| 90461 | 2.4% | 3,793 | 3,701 | $98K | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.2% | 1,703 | 1,699 | $89K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.4% | 817 | 808 | $57K |
| S9451 | Exercise classes, non-physician provider, per session | 1.3% | 8,256 | 8,238 | $54K |
48 more codes
| 90671 | 1.1% | 380 | $47K | |
| 90697 | <1% | 419 | $40K | |
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | <1% | 1,258 | $34K |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 473 | $33K |
| 90658 | <1% | 3,309 | $30K | |
| 90619 | <1% | 406 | $20K | |
| 90621 | <1% | 1,276 | $18K | |
| G0445 | High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes | <1% | 1,325 | $16K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,088 | $15K |
| 90651 | <1% | 1,525 | $15K | |
| G0270 | Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes | <1% | 7,984 | $12K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,164 | $11K |
| 0071A | <1% | 242 | $9K | |
| 96127 | <1% | 3,851 | $8K | |
| 90655 | <1% | 744 | $7K | |
| 0072A | <1% | 184 | $7K | |
| 81002 | <1% | 3,912 | $7K | |
| 90670 | <1% | 1,484 | $6K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 68 | $3K |
| 99460 | <1% | 57 | $3K | |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | <1% | 1,440 | $3K |
| 0001A | <1% | 53 | $2K | |
| 0003A | <1% | 49 | $2K | |
| 99442 | <1% | 47 | $2K | |
| 90620 | <1% | 59 | $2K | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 1,301 | $1K |
| 0002A | <1% | 27 | $1K | |
| 97804 | <1% | 154 | $980.72 | |
| 0124A | <1% | 26 | $876.71 | |
| 0073A | <1% | 20 | $720.00 | |
| 90734 | <1% | 827 | $718.56 | |
| 90680 | <1% | 1,279 | $476.16 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 27 | $446.95 |
| 90633 | <1% | 1,365 | $445.80 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 25 | $431.37 |
| 90715 | <1% | 453 | $414.97 | |
| 97802 | <1% | 60 | $290.84 | |
| 90744 | <1% | 167 | $83.04 | |
| 90647 | <1% | 518 | $66.48 | |
| 91300 | <1% | 165 | $0.07 | |
| 91307 | <1% | 360 | $0.05 | |
| 90698 | 0% | 348 | $0.00 | |
| 90723 | 0% | 140 | $0.00 | |
| 90696 | 0% | 63 | $0.00 | |
| 90710 | 0% | 813 | $0.00 | |
| 99080 | 0% | 451 | $0.00 | |
| 90700 | 0% | 73 | $0.00 | |
| 91312 | 0% | 12 | $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.