Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Children's Community Care

Children's Community Care was paid $100K by Medicaid between Nov 2020 and Dec 2024, across 19 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 68% of everything it billed.

33Billing provider infoCHILDREN'S COMMUNITY CARE
MONROEVILLE, PA 15146
33aNPI1427066943assigned 08/03/2006
33bProvider typePediatrics Physician
28Total paid$100K
24GClaims2,326
24DCodes billed19
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers

Next to other Pediatrics Physician providers in Pennsylvania

Rank by total paid#487 of 1,257
Median peer was paid$45K
This provider vs. median2.2×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official MARTINEZ, LORI controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$5.0K$10K2018201920202021202220232024
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
YearClaimsPaid
202012$297.00
2022339$17K
2023946$31K
2024incomplete1,029$52K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 68% 758 714 $68K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 25% 415 400 $25K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4.0% 42 42 $4K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1.4% 13 13 $1K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1.3% 13 13 $1K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 12 12 $297.00
99173 <1% 120 109 $122.18
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 73 54 $38.99
96127 <1% 27 26 $27.50
96160 <1% 26 25 $20.32
92551 <1% 143 130 $8.80
90686 0% 317 310 $0.00
7 more codes
90677 0% 39 $0.00
90651 0% 43 $0.00
90656 0% 29 $0.00
90648 0% 68 $0.00
90670 0% 29 $0.00
G9920 Screening performed and negative 0% 114 $0.00
90661 0% 45 $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 officialMARTINEZ, LORI (EXECUTIVE ADMINISTRATOR III)
Same official

Other billing entities under MARTINEZ, LORI

Full network →
ProviderLocationPaid
Children's Community CareWexford, PA$5.17M
Children's Community CareSewickley, PA$3.28M
Children's Community CareUniontown, PA$1.02M
Children's Community CarePittsburgh, PA$898K
Childen's Community CareNew Castle, PA$646K
Children's Community CareMonongahela, PA$628K
Children's Community CareErie, PA$580K
Childen's Community CarePittsburgh, PA$535K
Childen's Community CareHummelstown, PA$522K
Children's Community CareYork, PA$500K
Children's Community CareHuntingdon, PA$470K
Children's Community CareWexford, PA$467K
Childen's Community CareCamp Hill, PA$438K
Children's Community CarePittsburgh, PA$414K
Children's Community CareNew Castle, PA$394K
Childen's Community CareHermitage, PA$276K
Children's Community CareNorth Huntingdon, PA$252K
Children's Community CareNatrona Heights, PA$207K
Children's Community CareWhite Oak, PA$181K
Childen's Community CareGrove City, PA$177K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.