Physician
Pediatric Health Specialists, INC
Pediatric Health Specialists, INC was paid $2.85M by Medicaid between Jan 2019 and Dec 2024, across 64 billing codes. Its largest line is 99391, Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) — 20% of everything it billed.
33Billing provider infoPEDIATRIC HEALTH SPECIALISTS, INC
IRVING, TX 75039
IRVING, TX 75039
33aNPI1528586054assigned 09/05/2017
33bProvider typePediatrics Physician
28Total paid$2.85M
24GClaims130,313
24DCodes billed64
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#166 of 1,136
Median peer was paid$329K
This provider vs. median8.7×
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 | |
|---|---|---|---|
| 2019 | 241 | $13K | |
| 2020 | 6,569 | $102K | |
| 2021 | 28,423 | $548K | |
| 2022 | 30,557 | $684K | |
| 2023 | 33,047 | $755K | |
| 2024incomplete | 31,476 | $744K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 20% | 7,909 | 7,545 | $579K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 20% | 7,808 | 7,529 | $574K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 15,404 | 14,001 | $548K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 12% | 29,867 | 12,652 | $342K |
| 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 | 7.1% | 4,113 | 3,866 | $202K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.8% | 1,353 | 1,320 | $108K |
| 99381 | 3.5% | 1,299 | 1,218 | $101K | |
| 87428 | 3.4% | 1,966 | 1,902 | $96K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.9% | 7,420 | 5,046 | $54K |
| 90461 | 1.3% | 8,695 | 7,546 | $37K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.3% | 773 | 736 | $36K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,146 | 2,050 | $28K |
52 more codes
| 87634 | <1% | 495 | $27K | |
| 92551 | <1% | 3,225 | $26K | |
| 96112 | <1% | 265 | $24K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 204 | $17K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 854 | $11K |
| 87807 | <1% | 902 | $9K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 402 | $9K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 123 | $8K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 165 | $4K |
| 83655 | <1% | 194 | $2K | |
| 96380 | <1% | 64 | $1K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 18 | $984.96 |
| 0071A | <1% | 13 | $520.00 | |
| 85018 | <1% | 212 | $370.90 | |
| 0081A | <1% | 15 | $310.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 15 | $165.95 |
| 81002 | <1% | 55 | $157.68 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 13 | $101.92 |
| 90674 | <1% | 544 | $48.77 | |
| 90661 | <1% | 568 | $32.52 | |
| 96127 | <1% | 77 | $23.10 | |
| 90696 | <1% | 519 | $1.49 | |
| 90710 | 0% | 1,060 | $0.00 | |
| 90681 | 0% | 1,856 | $0.00 | |
| 90648 | 0% | 3,659 | $0.00 | |
| 90670 | 0% | 4,290 | $0.00 | |
| 99072 | 0% | 1,403 | $0.00 | |
| 90707 | 0% | 811 | $0.00 | |
| 90700 | 0% | 1,146 | $0.00 | |
| 99173 | 0% | 3,139 | $0.00 | |
| 91308 | 0% | 18 | $0.00 | |
| 90633 | 0% | 3,320 | $0.00 | |
| 90734 | 0% | 31 | $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% | 126 | $0.00 |
| 90715 | 0% | 13 | $0.00 | |
| 90380 | 0% | 25 | $0.00 | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 0% | 50 | $0.00 |
| 90685 | 0% | 36 | $0.00 | |
| 90381 | 0% | 146 | $0.00 | |
| 90716 | 0% | 792 | $0.00 | |
| 90723 | 0% | 2,734 | $0.00 | |
| 90677 | 0% | 2,159 | $0.00 | |
| 90697 | 0% | 1,869 | $0.00 | |
| 90688 | 0% | 1,340 | $0.00 | |
| 90680 | 0% | 1,540 | $0.00 | |
| 90686 | 0% | 378 | $0.00 | |
| 90647 | 0% | 131 | $0.00 | |
| 36416 | 0% | 114 | $0.00 | |
| 90698 | 0% | 232 | $0.00 | |
| 90651 | 0% | 83 | $0.00 | |
| 91307 | 0% | 36 | $0.00 | |
| 90656 | 0% | 81 | $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 officialSUTERWALA, SMITA (PRESIDENT/CEO)