Physician
South Lake Clinic, P.A.
South Lake Clinic, P.A. was paid $5.88M by Medicaid between Jan 2018 and Dec 2024, across 61 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.
33Billing provider infoSOUTH LAKE CLINIC, P.A.
MINNETONKA, MN 55345
MINNETONKA, MN 55345
33aNPI1427027184assigned 03/15/2006
33bProvider typePediatrics Physician
28Total paid$5.88M
24GClaims220,247
24DCodes billed61
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Minnesota
Rank by total paid#4 of 33
Median peer was paid$13K
This provider vs. median447×
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 | 50,503 | $380K | |
| 2019 | 44,418 | $1.23M | |
| 2020 | 31,589 | $948K | |
| 2021 | 31,204 | $1.12M | |
| 2022 | 24,786 | $939K | |
| 2023 | 19,386 | $655K | |
| 2024incomplete | 18,361 | $608K |
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 | 24% | 28,790 | 26,194 | $1.41M |
| 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 | 18% | 14,924 | 13,252 | $1.08M |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 18% | 27,318 | 25,674 | $1.05M |
| X5622 | 8.2% | 10,211 | 9,329 | $484K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 5.0% | 14,499 | 13,809 | $293K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.7% | 4,938 | 4,736 | $277K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.7% | 3,964 | 3,832 | $219K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.7% | 4,303 | 3,881 | $215K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.8% | 1,690 | 1,621 | $106K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1.7% | 693 | 678 | $98K |
| 90461 | 1.1% | 3,673 | 3,489 | $67K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.1% | 13,904 | 11,580 | $66K |
49 more codes
| 92551 | 1.0% | 12,537 | $61K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.0% | 1,804 | $61K |
| 96127 | 1.0% | 16,852 | $60K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 606 | $55K |
| 99000 | <1% | 4,656 | $51K | |
| 99188 | <1% | 7,140 | $49K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,040 | $34K |
| 87430 | <1% | 2,897 | $32K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,861 | $18K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,709 | $18K |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | <1% | 3,300 | $14K |
| 99173 | <1% | 12,252 | $13K | |
| 87081 | <1% | 2,061 | $9K | |
| 36416 | <1% | 2,288 | $6K | |
| 90686 | <1% | 6,232 | $5K | |
| 90670 | <1% | 2,496 | $4K | |
| 90691 | <1% | 37 | $4K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 64 | $3K |
| T1013 | Sign language or oral interpretive services, per 15 minutes | <1% | 130 | $3K |
| 90698 | <1% | 2,332 | $2K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 766 | $2K |
| 85018 | <1% | 871 | $2K | |
| 90480 | <1% | 29 | $966.34 | |
| 90651 | <1% | 621 | $913.16 | |
| 0001A | <1% | 34 | $796.20 | |
| 90734 | <1% | 340 | $670.47 | |
| 96161 | <1% | 683 | $534.91 | |
| 0111A | <1% | 13 | $445.64 | |
| 90677 | <1% | 60 | $374.04 | |
| 90680 | <1% | 923 | $360.00 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 39 | $349.41 |
| 90744 | <1% | 611 | $320.00 | |
| 90710 | <1% | 25 | $287.61 | |
| 0002A | <1% | 17 | $237.66 | |
| 90633 | <1% | 898 | $228.99 | |
| 87807 | <1% | 29 | $224.27 | |
| 90715 | <1% | 96 | $214.66 | |
| 90656 | <1% | 221 | $188.56 | |
| 90716 | <1% | 171 | $161.90 | |
| 90672 | <1% | 54 | $140.00 | |
| 90707 | <1% | 54 | $106.53 | |
| 90473 | <1% | 12 | $87.57 | |
| 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% | 1,820 | $66.88 |
| 90696 | <1% | 84 | $60.00 | |
| 99177 | <1% | 13 | $57.12 | |
| 90685 | <1% | 476 | $50.00 | |
| 81003 | <1% | 12 | $28.44 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 13 | $0.00 |
| 98962 | 0% | 61 | $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 officialDOBRIN, DALE (OWNER/MEDICAL DIRECTOR)