Vergara, Gracie

Vergara, Gracie was paid $55K by Medicaid between Jan 2018 and Jul 2018, across 21 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 38% of everything it billed.

33Billing provider infoVERGARA, GRACIE
SUFFOLK, VA 23434

33aNPI1538120290assigned 03/31/2006

33bProvider typePediatrics Physician

28Total paid$55K

24GClaims1,441

24DCodes billed21

24AFirst – last monthJan 2018 – Jul 2018

Compared with peers

Next to other Pediatrics Physician providers in Virginia

Rank by total paid#310 of 817

Median peer was paid$29K

This provider vs. median1.9×

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	1,441	$55K

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	38%	323	303	$21K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	19%	123	120	$11K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	15%	103	98	$8K
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	8.2%	47	46	$5K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	3.5%	120	59	$2K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	3.3%	47	45	$2K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	2.8%	94	93	$2K
90698		2.5%	107	101	$1K
90670		2.0%	82	79	$1K
92551		1.3%	60	60	$709.11
96127		1.1%	110	98	$584.85
90680		<1%	40	38	$442.75

9 more codes

90633		<1%	26	$277.75
99174		<1%	30	$228.77
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	24	$227.03
83655		<1%	12	$194.22
90686		<1%	16	$178.75
90651		<1%	12	$140.25
99173		<1%	14	$40.56
85018		<1%	12	$38.06
36416		<1%	39	$34.80

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.