Clinic
East Lyme Pediatric Clinic, LLC
East Lyme Pediatric Clinic, LLC was paid $6.74M by Medicaid between Jan 2018 and Dec 2024, across 47 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 26% of everything it billed.
33Billing provider infoEAST LYME PEDIATRIC CLINIC, LLC
NIANTIC, CT 06357
NIANTIC, CT 06357
33aNPI1326265745assigned 04/19/2007
33bProvider typePrimary Care Clinic/Center
28Total paid$6.74M
24GClaims189,655
24DCodes billed47
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Connecticut
Rank by total paid#3 of 36
Median peer was paid$63K
This provider vs. median106×
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 | 24,152 | $924K | |
| 2019 | 24,911 | $864K | |
| 2020 | 24,496 | $872K | |
| 2021 | 23,834 | $950K | |
| 2022 | 28,618 | $999K | |
| 2023 | 35,018 | $1.06M | |
| 2024incomplete | 28,626 | $1.08M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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% | 16,479 | 13,681 | $1.74M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 22% | 21,350 | 18,023 | $1.49M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 7.5% | 15,270 | 13,951 | $507K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.2% | 4,245 | 3,905 | $487K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.7% | 3,724 | 3,386 | $452K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.8% | 3,611 | 3,120 | $390K |
| 92015 | Determination of refractive state | 4.6% | 8,555 | 7,624 | $307K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.5% | 2,466 | 2,316 | $302K |
| 96127 | 4.4% | 14,826 | 10,408 | $299K | |
| 92587 | 3.8% | 8,597 | 7,724 | $257K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.1% | 10,003 | 6,866 | $208K |
| 96160 | <1% | 3,214 | 2,878 | $58K |
35 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 6,284 | $55K |
| 36416 | <1% | 16,061 | $38K | |
| 87428 | <1% | 1,109 | $35K | |
| 96161 | <1% | 1,527 | $29K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,098 | $20K |
| 92551 | <1% | 2,467 | $15K | |
| 99173 | <1% | 2,111 | $15K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 394 | $7K |
| 99188 | <1% | 474 | $7K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 172 | $6K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 154 | $4K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 67 | $2K |
| 99442 | <1% | 62 | $2K | |
| 99051 | <1% | 219 | $2K | |
| 87807 | <1% | 245 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 16 | $1K |
| 87420 | <1% | 138 | $1K | |
| 83655 | <1% | 134 | $1K | |
| 90651 | <1% | 807 | $275.00 | |
| 94760 | <1% | 145 | $165.59 | |
| 90686 | <1% | 7,549 | $152.29 | |
| 85018 | <1% | 15,702 | $118.82 | |
| 81003 | <1% | 8,826 | $111.27 | |
| 90670 | <1% | 1,258 | $0.02 | |
| 90461 | 0% | 4,976 | $0.00 | |
| 90633 | 0% | 197 | $0.00 | |
| 90734 | 0% | 178 | $0.00 | |
| 90715 | 0% | 13 | $0.00 | |
| 90685 | 0% | 13 | $0.00 | |
| 99000 | 0% | 2,740 | $0.00 | |
| 90677 | 0% | 229 | $0.00 | |
| 90744 | 0% | 103 | $0.00 | |
| 90680 | 0% | 299 | $0.00 | |
| 90620 | 0% | 38 | $0.00 | |
| 90698 | 0% | 510 | $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.
From NPPES
Who's on the registration
Authorized officialMALIK, SAJDA (MEMBER)