Physician
English Road Pediatrics and Adolescent Medicine
English Road Pediatrics and Adolescent Medicine was paid $8.05M by Medicaid between Jan 2018 and Dec 2024, across 57 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.
33Billing provider infoENGLISH ROAD PEDIATRICS AND ADOLESCENT MEDICINE
ROCHESTER, NY 14616
ROCHESTER, NY 14616
33aNPI1346395126assigned 01/24/2007
33bProvider typePediatrics Physician
28Total paid$8.05M
24GClaims162,704
24DCodes billed57
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in New York
Rank by total paid#31 of 1,983
Median peer was paid$17K
This provider vs. median474×
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 | 11,117 | $542K | |
| 2019 | 15,949 | $722K | |
| 2020 | 24,559 | $1.07M | |
| 2021 | 29,346 | $1.39M | |
| 2022 | 31,101 | $1.59M | |
| 2023 | 27,497 | $1.51M | |
| 2024incomplete | 23,135 | $1.22M |
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 | 37% | 45,406 | 42,985 | $2.96M |
| 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 | 14% | 11,651 | 11,298 | $1.13M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 22,356 | 22,080 | $833K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 9.7% | 5,164 | 5,103 | $782K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.0% | 6,079 | 6,079 | $561K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.9% | 5,901 | 5,901 | $559K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.8% | 3,072 | 3,072 | $306K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.5% | 3,190 | 2,985 | $283K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.6% | 4,549 | 4,491 | $127K |
| 99051 | 1.4% | 13,635 | 13,316 | $116K | |
| 92551 | 1.3% | 14,787 | 14,782 | $106K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,404 | 2,390 | $43K |
45 more codes
| H0049 | Alcohol and/or drug screening | <1% | 1,137 | $37K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 607 | $31K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 1,165 | $18K |
| 99173 | <1% | 9,922 | $18K | |
| 96127 | <1% | 2,882 | $13K | |
| 0072A | <1% | 288 | $12K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 808 | $10K |
| 0002A | <1% | 258 | $10K | |
| 0071A | <1% | 267 | $10K | |
| 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% | 580 | $9K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 710 | $9K |
| 0001A | <1% | 207 | $8K | |
| 99050 | <1% | 368 | $8K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 83 | $7K |
| 96160 | <1% | 2,239 | $5K | |
| 99354 | <1% | 29 | $3K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 211 | $3K |
| 96161 | <1% | 1,030 | $2K | |
| 90686 | <1% | 521 | $2K | |
| 83655 | <1% | 124 | $2K | |
| 0003A | <1% | 42 | $2K | |
| 90480 | <1% | 43 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 92 | $2K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 86 | $2K |
| 87400 | <1% | 113 | $1K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12 | $1K |
| 87631 | <1% | 12 | $1K | |
| 0012A | <1% | 29 | $1K | |
| 0124A | <1% | 28 | $1K | |
| 0011A | <1% | 26 | $1K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 19 | $818.76 |
| 0082A | <1% | 16 | $640.00 | |
| 80061 | Lipid panel | <1% | 65 | $629.07 |
| 0052A | <1% | 15 | $604.26 | |
| 0083A | <1% | 15 | $581.88 | |
| 0053A | <1% | 14 | $572.78 | |
| 0081A | <1% | 12 | $480.00 | |
| 85018 | <1% | 174 | $400.51 | |
| 98966 | <1% | 31 | $377.84 | |
| 90656 | <1% | 34 | $214.91 | |
| 99177 | <1% | 27 | $86.73 | |
| J8540 | Dexamethasone, oral, 0.25 mg | <1% | 29 | $31.82 |
| 99000 | 0% | 76 | $0.00 | |
| 91307 | 0% | 52 | $0.00 | |
| 90713 | 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.
From NPPES
Who's on the registration
Authorized officialO'GARA, KEVIN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| West End Pediatric Urgent Care LLC | Rochester, NY | $1.03M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.