Physician
Marblehead Pediatrics
Marblehead Pediatrics was paid $141K by Medicaid between Jan 2018 and Nov 2024, across 15 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 81% of everything it billed.
33Billing provider infoMARBLEHEAD PEDIATRICS
MARBLEHEAD, MA 01945
MARBLEHEAD, MA 01945
33aNPI1386794584assigned 01/11/2007
33bProvider typePediatrics Physician
28Total paid$141K
24GClaims4,599
24DCodes billed15
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in Massachusetts
Rank by total paid#346 of 1,273
Median peer was paid$24K
This provider vs. median5.9×
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 | 865 | $37K | |
| 2019 | 846 | $35K | |
| 2020 | 929 | $19K | |
| 2021 | 629 | $19K | |
| 2022 | 478 | $21K | |
| 2023 | 533 | $8K | |
| 2024incomplete | 319 | $2K |
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 | 81% | 2,177 | 2,008 | $113K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 7.5% | 1,108 | 1,103 | $11K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.7% | 338 | 321 | $7K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.1% | 152 | 152 | $3K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.8% | 254 | 254 | $3K |
| 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 | <1% | 25 | 25 | $1K |
| 0071A | <1% | 20 | 20 | $917.40 | |
| 0072A | <1% | 18 | 18 | $825.66 | |
| 90461 | <1% | 24 | 24 | $724.20 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 13 | 13 | $667.03 |
| 96127 | <1% | 39 | 38 | $267.02 | |
| 99441 | <1% | 16 | 13 | $172.32 |
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 officialGAST, LISA (PRESIDENT)