Modesto Pediatrics

Modesto Pediatrics was paid $446K by Medicaid between Jan 2018 and Dec 2024, across 33 billing codes. Its largest line is 96110, Developmental screening, with scoring and documentation, per standardized instrument — 42% of everything it billed.

33Billing provider infoMODESTO PEDIATRICS
MODESTO, CA 95355

33aNPI1366547796assigned 09/13/2006

33bProvider typePediatrics Physician

28Total paid$446K

24GClaims28,442

24DCodes billed33

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pediatrics Physician providers in California

Rank by total paid#245 of 1,490

Median peer was paid$15K

This provider vs. median30×

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	2,074	$37K
2019	2,816	$37K
2020	2,471	$38K
2021	3,996	$62K
2022	6,001	$91K
2023	5,265	$86K
2024incomplete	5,819	$96K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
96110	Developmental screening, with scoring and documentation, per standardized instrument	42%	3,436	3,342	$187K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	15%	3,479	3,367	$65K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	14%	6,817	6,124	$64K
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	9.6%	2,682	2,489	$43K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	7.1%	1,186	1,181	$32K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	4.2%	1,694	1,685	$19K
87428		<1%	60	58	$4K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	718	687	$4K
96127		<1%	643	642	$3K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	462	450	$3K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	153	153	$3K
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	<1%	69	67	$2K

21 more codes

90723		<1%	771	$2K
92551		<1%	991	$2K
81002		<1%	1,010	$2K
90648		<1%	1,253	$2K
90670		<1%	901	$2K
90680		<1%	458	$1K
99173		<1%	240	$978.10
99401		<1%	399	$864.55
83655		<1%	58	$714.56
90671		<1%	199	$604.56
90633		<1%	306	$381.05
90686		<1%	235	$377.53
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	34	$261.67
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	17	$236.65
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	33	$140.26
94760		<1%	28	$86.05
90681		<1%	38	$54.00
99000		<1%	14	$47.19
90647		<1%	14	$27.00
90700		<1%	25	$27.00
J7613	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	<1%	19	$0.97

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 officialTRUSCELLO, ANN (PRESIDENT)