Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

307 PEDIATRICS LLC

NPI: 1265288526 · CASPER, WY 82601 · Pediatrics Physician · NPI assigned 04/27/2024

$14K
Total Medicaid Paid
284
Total Claims
271
Beneficiaries
6
Codes Billed
2024-08
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPETERSON, JESSICA (CPNP-PC)
NPI Enumeration Date04/27/2024

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 284 $14K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 105 97 $6K
90677 12 12 $3K
90460 Immunization administration through 18 years of age via any route, first or only component 93 89 $3K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 13 13 $1K
96110 Developmental screening, with scoring and documentation, per standardized instrument 49 48 $788.34
90461 12 12 $0.00