NP / PA
Poole and Thomas Pediatrics, PLC
Poole and Thomas Pediatrics, PLC was paid $171K by Medicaid between Jan 2018 and Nov 2024, across 10 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 72% of everything it billed.
33Billing provider infoPOOLE AND THOMAS PEDIATRICS, PLC
LEXINGTON, KY 40503
LEXINGTON, KY 40503
33aNPI1396002473assigned 04/13/2012
33bProvider typeFamily Nurse Practitioner
28Total paid$171K
24GClaims5,951
24DCodes billed10
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Family Nurse Practitioner providers in Kentucky
Rank by total paid#89 of 424
Median peer was paid$19K
This provider vs. median9.1×
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 | 737 | $23K | |
| 2019 | 723 | $22K | |
| 2020 | 542 | $14K | |
| 2021 | 716 | $23K | |
| 2022 | 1,257 | $43K | |
| 2023 | 980 | $30K | |
| 2024incomplete | 996 | $15K |
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 | 72% | 3,604 | 3,214 | $122K |
| 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 | 16% | 525 | 465 | $28K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.6% | 508 | 424 | $11K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.7% | 216 | 104 | $3K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.2% | 97 | 90 | $2K |
| 90686 | 1.2% | 302 | 295 | $2K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 147 | 137 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 22 | 21 | $349.81 |
| 87070 | <1% | 29 | 28 | $175.40 | |
| 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) | 0% | 501 | 438 | $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 officialSANDEFUR, LAURA (PRACTICE ADMINISTRATOR)