Physician
Athens Pediatrics PLLC
Athens Pediatrics PLLC was paid $4.35M by Medicaid between Jan 2018 and Dec 2024, across 61 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 26% of everything it billed.
33Billing provider infoATHENS PEDIATRICS PLLC
ATHENS, TN 37303
ATHENS, TN 37303
33aNPI1437397809assigned 01/23/2009
33bProvider typePediatrics Physician
28Total paid$4.35M
24GClaims185,453
24DCodes billed61
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Tennessee
Rank by total paid#27 of 333
Median peer was paid$139K
This provider vs. median31×
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 | 21,880 | $419K | |
| 2019 | 28,959 | $671K | |
| 2020 | 26,526 | $584K | |
| 2021 | 28,824 | $666K | |
| 2022 | 26,747 | $680K | |
| 2023 | 27,541 | $698K | |
| 2024incomplete | 24,976 | $635K |
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 | 26% | 25,696 | 21,953 | $1.14M |
| 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 | 20% | 13,058 | 11,191 | $876K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 10,845 | 9,605 | $483K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.6% | 5,202 | 4,335 | $331K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.3% | 3,773 | 3,513 | $273K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 5.5% | 9,552 | 7,413 | $241K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.0% | 2,379 | 2,115 | $173K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.8% | 3,516 | 3,038 | $124K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.5% | 1,277 | 1,098 | $108K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 2.4% | 3,260 | 2,948 | $102K |
| 96161 | 1.6% | 4,757 | 3,706 | $70K | |
| 96127 | 1.5% | 15,024 | 9,342 | $65K |
49 more codes
| 92551 | 1.2% | 6,762 | $52K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.1% | 4,345 | $49K |
| 90834 | Psychotherapy session, about 45 minutes | 1.1% | 775 | $46K |
| 99173 | <1% | 6,663 | $35K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 688 | $27K |
| 36416 | <1% | 14,329 | $23K | |
| 85014 | <1% | 8,950 | $20K | |
| 81002 | <1% | 6,025 | $14K | |
| 96160 | <1% | 2,365 | $13K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 151 | $13K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,244 | $13K |
| 3008F | <1% | 8,855 | $10K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,067 | $9K |
| 85018 | <1% | 3,444 | $8K | |
| 83655 | <1% | 596 | $7K | |
| 99381 | <1% | 62 | $5K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 131 | $4K |
| 87807 | <1% | 330 | $3K | |
| 99177 | <1% | 432 | $3K | |
| 90677 | <1% | 587 | $3K | |
| 90651 | <1% | 290 | $2K | |
| 87081 | <1% | 1,173 | $2K | |
| 69210 | <1% | 42 | $2K | |
| 99460 | <1% | 21 | $1K | |
| 81000 | <1% | 413 | $1K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 17 | $1K |
| 90670 | <1% | 2,549 | $982.13 | |
| 90686 | <1% | 1,987 | $919.33 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 12 | $691.38 |
| 99462 | <1% | 23 | $644.73 | |
| 90734 | <1% | 146 | $516.63 | |
| 90723 | <1% | 1,713 | $212.16 | |
| 90716 | <1% | 407 | $196.64 | |
| 90661 | <1% | 94 | $138.55 | |
| 90680 | <1% | 1,827 | $133.47 | |
| 90707 | <1% | 435 | $110.07 | |
| 90674 | <1% | 192 | $100.00 | |
| 90647 | <1% | 1,684 | $51.18 | |
| 90633 | <1% | 540 | $35.04 | |
| 90697 | <1% | 400 | $34.13 | |
| 99051 | <1% | 40 | $30.68 | |
| 99072 | 0% | 4,946 | $0.00 | |
| 90700 | 0% | 26 | $0.00 | |
| 90715 | 0% | 25 | $0.00 | |
| 99000 | 0% | 136 | $0.00 | |
| 90619 | 0% | 59 | $0.00 | |
| 90688 | 0% | 48 | $0.00 | |
| 90656 | 0% | 54 | $0.00 | |
| 90696 | 0% | 14 | $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 officialACKAOUY, CINDY (OFFICE MANAGER)