Clinic
Franconia Pediatrics Associates
Franconia Pediatrics Associates was paid $3.03M by Medicaid between Jan 2018 and Dec 2024, across 66 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 41% of everything it billed.
33Billing provider infoFRANCONIA PEDIATRICS ASSOCIATES
ALEXANDRIA, VA 22310
ALEXANDRIA, VA 22310
33aNPI1336542042assigned 10/08/2014
33bProvider typePrimary Care Clinic/Center
28Total paid$3.03M
24GClaims95,978
24DCodes billed66
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Virginia
Rank by total paid#5 of 80
Median peer was paid$108K
This provider vs. median28×
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 | 11,410 | $358K | |
| 2019 | 13,266 | $376K | |
| 2020 | 12,172 | $378K | |
| 2021 | 13,146 | $416K | |
| 2022 | 15,429 | $510K | |
| 2023 | 16,262 | $530K | |
| 2024incomplete | 14,293 | $458K |
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 | 41% | 20,724 | 17,588 | $1.24M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 10% | 4,163 | 4,069 | $317K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.0% | 3,540 | 3,455 | $271K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 7.8% | 2,859 | 2,777 | $236K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.6% | 2,403 | 2,183 | $171K |
| 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 | 4.6% | 1,700 | 1,516 | $138K |
| 92551 | 2.6% | 8,028 | 7,839 | $77K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.3% | 2,067 | 1,966 | $69K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.0% | 6,708 | 5,845 | $61K |
| 90651 | 1.8% | 1,363 | 1,326 | $53K | |
| 90670 | 1.3% | 1,691 | 1,635 | $40K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.2% | 2,746 | 2,578 | $35K |
54 more codes
| 90686 | <1% | 2,521 | $29K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,954 | $26K |
| 81002 | <1% | 7,980 | $22K | |
| 90680 | <1% | 1,283 | $21K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 575 | $20K |
| 99173 | <1% | 8,120 | $19K | |
| 90619 | <1% | 400 | $16K | |
| 96127 | <1% | 3,281 | $15K | |
| 90734 | <1% | 489 | $15K | |
| 90633 | <1% | 1,159 | $15K | |
| 90710 | <1% | 598 | $13K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 821 | $13K |
| 90698 | <1% | 777 | $13K | |
| 90677 | <1% | 260 | $12K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 122 | $10K |
| 0072A | <1% | 171 | $7K | |
| 0071A | <1% | 168 | $7K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 500 | $5K |
| 90647 | <1% | 353 | $4K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 131 | $4K |
| 90715 | <1% | 236 | $4K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 465 | $4K |
| 90744 | <1% | 259 | $3K | |
| 90672 | <1% | 117 | $2K | |
| 90621 | <1% | 51 | $2K | |
| 87428 | <1% | 77 | $2K | |
| 90656 | <1% | 148 | $2K | |
| 99174 | <1% | 439 | $2K | |
| 90700 | <1% | 161 | $2K | |
| 90620 | <1% | 73 | $2K | |
| A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable | <1% | 144 | $2K |
| 0001A | <1% | 38 | $1K | |
| 90696 | <1% | 69 | $1K | |
| A7006 | Administration set, with small volume filtered pneumatic nebulizer | <1% | 195 | $944.26 |
| 0002A | <1% | 21 | $840.00 | |
| 99000 | <1% | 256 | $706.56 | |
| 96161 | <1% | 542 | $584.73 | |
| 94760 | <1% | 406 | $533.69 | |
| 87807 | <1% | 36 | $408.08 | |
| 99050 | <1% | 32 | $374.13 | |
| 99188 | <1% | 13 | $270.27 | |
| 90723 | <1% | 15 | $244.04 | |
| 97802 | <1% | 138 | $183.72 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 45 | $161.10 |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable | <1% | 86 | $117.89 |
| A7015 | Aerosol mask, used with dme nebulizer | <1% | 111 | $110.57 |
| 99051 | <1% | 65 | $88.50 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 369 | $14.46 |
| J7611 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg | <1% | 97 | $12.45 |
| 91307 | <1% | 393 | $2.56 | |
| 91300 | <1% | 70 | $0.43 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 1,095 | $0.00 |
| 99072 | 0% | 47 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 14 | $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 officialNAVALKAR, SUSHANT (OWNER)