Lower Falls Pediatrics

Lower Falls Pediatrics was paid $24K by Medicaid between Jun 2018 and Oct 2024, across 7 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 53% of everything it billed.

33Billing provider infoLOWER FALLS PEDIATRICS
WELLESLEY HILLS, MA 02481

33aNPI1356569735assigned 04/23/2007

33bProvider typePediatrics Physician

28Total paid$24K

24GClaims982

24DCodes billed7

24AFirst – last monthJun 2018 – Oct 2024

Compared with peers

Next to other Pediatrics Physician providers in Massachusetts

Rank by total paid#641 of 1,273

Median peer was paid$24K

This provider vs. median1.0×

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	114	$2K
2019	151	$5K
2020	262	$5K
2021	187	$7K
2022	96	$4K
2023	86	$2K
2024incomplete	86	$294.99

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	53%	275	262	$13K
90460	Immunization administration through 18 years of age via any route, first or only component	21%	318	266	$5K
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	19%	61	56	$4K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	3.2%	19	17	$762.60
96110	Developmental screening, with scoring and documentation, per standardized instrument	2.4%	180	174	$566.39
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	1.2%	32	31	$286.20
90686		<1%	97	91	$38.61

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 officialGARA-MATTHEWS, LORI (PRESIDENT)