Physician
Pediatricare PM
Pediatricare PM was paid $2.77M by Medicaid between Jan 2018 and Dec 2024, across 63 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
33Billing provider infoPEDIATRICARE PM
AUGUSTA, GA 30909
AUGUSTA, GA 30909
33aNPI1497820468assigned 11/22/2006
33bProvider typePediatrics Physician
28Total paid$2.77M
24GClaims79,507
24DCodes billed63
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Georgia
Rank by total paid#31 of 220
Median peer was paid$57K
This provider vs. median48×
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 | 10,879 | $369K | |
| 2019 | 9,968 | $350K | |
| 2020 | 12,212 | $356K | |
| 2021 | 11,608 | $413K | |
| 2022 | 15,600 | $551K | |
| 2023 | 11,376 | $424K | |
| 2024incomplete | 7,864 | $303K |
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 | 35% | 14,677 | 13,422 | $980K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 14% | 8,162 | 7,692 | $386K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10.0% | 3,035 | 2,742 | $276K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.9% | 2,505 | 2,421 | $247K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.3% | 2,560 | 2,280 | $229K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.9% | 4,290 | 3,891 | $163K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.6% | 1,228 | 1,152 | $127K |
| 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 | 4.3% | 1,166 | 1,099 | $118K |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 1.9% | 667 | 640 | $54K |
| 99050 | <1% | 1,809 | 1,730 | $27K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 2,763 | 2,404 | $25K |
| 85018 | <1% | 7,348 | 6,890 | $21K |
51 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,235 | $20K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 375 | $13K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 877 | $11K |
| 92551 | <1% | 3,977 | $10K | |
| 81002 | <1% | 3,219 | $10K | |
| 96127 | <1% | 2,199 | $10K | |
| 99429 | <1% | 669 | $6K | |
| 99173 | <1% | 4,211 | $5K | |
| 96160 | <1% | 1,863 | $5K | |
| 99460 | <1% | 57 | $5K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 50 | $3K |
| 0072A | <1% | 71 | $3K | |
| 96161 | <1% | 958 | $3K | |
| 99188 | <1% | 130 | $2K | |
| 83655 | <1% | 235 | $2K | |
| 0071A | <1% | 32 | $1K | |
| 87807 | <1% | 43 | $669.44 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 1,403 | $545.10 |
| 90651 | <1% | 292 | $363.00 | |
| 90671 | <1% | 412 | $246.20 | |
| 90620 | <1% | 397 | $243.02 | |
| 90670 | <1% | 1,253 | $216.89 | |
| 90619 | <1% | 58 | $171.02 | |
| 86580 | <1% | 16 | $110.48 | |
| 90633 | <1% | 323 | $52.72 | |
| 90686 | <1% | 1,236 | $0.01 | |
| 90648 | 0% | 540 | $0.00 | |
| 90685 | 0% | 58 | $0.00 | |
| 3078F | 0% | 70 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 275 | $0.00 |
| 90681 | 0% | 67 | $0.00 | |
| 1160F | 0% | 140 | $0.00 | |
| 90700 | 0% | 76 | $0.00 | |
| 90715 | 0% | 29 | $0.00 | |
| 90734 | 0% | 86 | $0.00 | |
| 90710 | 0% | 26 | $0.00 | |
| 90707 | 0% | 14 | $0.00 | |
| 90713 | 0% | 17 | $0.00 | |
| 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% | 18 | $0.00 |
| 90672 | 0% | 16 | $0.00 | |
| 90680 | 0% | 697 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 276 | $0.00 |
| 36416 | 0% | 158 | $0.00 | |
| 90723 | 0% | 370 | $0.00 | |
| 3008F | 0% | 177 | $0.00 | |
| 90716 | 0% | 48 | $0.00 | |
| 90698 | 0% | 53 | $0.00 | |
| 90647 | 0% | 313 | $0.00 | |
| 90696 | 0% | 27 | $0.00 | |
| 91307 | 0% | 124 | $0.00 | |
| 3074F | 0% | 31 | $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 officialCOOK, TERRI (BUSINESS MANAGER)