Physician
Prima INC
Prima INC was paid $1.01M by Medicaid between Jan 2018 and Dec 2024, across 27 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 44% of everything it billed.
33Billing provider infoPRIMA INC
CUMBERLAND, RI 02864
CUMBERLAND, RI 02864
33aNPI1285664524assigned 07/03/2006
33bProvider typePediatrics Physician
28Total paid$1.01M
24GClaims21,976
24DCodes billed27
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Rhode Island
Rank by total paid#17 of 265
Median peer was paid$133K
This provider vs. median7.6×
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 | 3,379 | $127K | |
| 2019 | 6,588 | $245K | |
| 2020 | 2,369 | $84K | |
| 2021 | 2,232 | $90K | |
| 2022 | 2,292 | $135K | |
| 2023 | 1,992 | $131K | |
| 2024incomplete | 3,124 | $201K |
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 | 44% | 7,143 | 6,155 | $450K |
| 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 | 26% | 2,927 | 2,697 | $264K |
| 92587 | 6.0% | 1,084 | 1,066 | $60K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 4.5% | 370 | 360 | $45K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.3% | 2,906 | 2,763 | $44K |
| 97802 | 3.5% | 1,835 | 1,754 | $35K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.7% | 2,039 | 1,956 | $27K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.1% | 235 | 229 | $21K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.5% | 156 | 156 | $15K |
| 90461 | 1.1% | 435 | 407 | $12K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 79 | 79 | $8K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 515 | 479 | $6K |
15 more codes
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 49 | $5K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 429 | $4K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 130 | $4K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 310 | $3K |
| 99177 | <1% | 335 | $2K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 83 | $1K |
| 81002 | <1% | 485 | $1K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 35 | $861.45 |
| 99050 | <1% | 13 | $536.52 | |
| 92552 | <1% | 29 | $484.93 | |
| 96127 | <1% | 165 | $469.33 | |
| 0071A | <1% | 12 | $389.90 | |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 82 | $209.67 |
| 99188 | <1% | 13 | $175.50 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 82 | $3.08 |
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 officialO'SHEA, CAROL (PEDIATRICIAN)