Lab
Pediatric Specialists of Franklin County
Pediatric Specialists of Franklin County was paid $1.20M by Medicaid between Oct 2018 and Dec 2024, across 40 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 40% of everything it billed.
33Billing provider infoPEDIATRIC SPECIALISTS OF FRANKLIN COUNTY
WAYNESBORO, PA 17268
WAYNESBORO, PA 17268
33aNPI1538373709assigned 05/09/2007
33bProvider typeClinical Medical Laboratory
28Total paid$1.20M
24GClaims32,970
24DCodes billed40
24AFirst – last monthOct 2018 – Dec 2024
Compared with peers
Next to other Clinical Medical Laboratory providers in Pennsylvania
Rank by total paid#24 of 95
Median peer was paid$153K
This provider vs. median7.9×
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 | 106 | $4K | |
| 2019 | 165 | $6K | |
| 2020 | 1,199 | $43K | |
| 2021 | 8,810 | $339K | |
| 2022 | 9,455 | $343K | |
| 2023 | 7,535 | $263K | |
| 2024incomplete | 5,700 | $203K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 40% | 7,981 | 7,191 | $475K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 24% | 7,590 | 6,680 | $293K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.6% | 1,124 | 1,110 | $103K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.0% | 652 | 649 | $60K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.6% | 618 | 585 | $56K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 3.5% | 1,045 | 1,003 | $41K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.4% | 2,239 | 1,101 | $29K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.2% | 290 | 287 | $26K |
| 99499 | 1.5% | 1,706 | 1,377 | $18K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.5% | 421 | 410 | $18K |
| 92551 | 1.3% | 1,862 | 1,842 | $15K | |
| 99173 | 1.1% | 2,140 | 2,117 | $13K |
28 more codes
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 631 | $12K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 430 | $6K |
| 99188 | <1% | 229 | $4K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 597 | $4K |
| 90686 | <1% | 607 | $4K | |
| 83655 | <1% | 636 | $3K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 334 | $3K |
| 87807 | <1% | 164 | $2K | |
| 0072A | <1% | 48 | $2K | |
| 0071A | <1% | 38 | $1K | |
| 90677 | <1% | 44 | $1K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 47 | $1K |
| 85018 | <1% | 374 | $1K | |
| 0001A | <1% | 27 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 94 | $1K |
| 90670 | <1% | 266 | $1K | |
| 90698 | <1% | 118 | $781.50 | |
| 0002A | <1% | 17 | $680.00 | |
| 90656 | <1% | 52 | $585.52 | |
| 96161 | <1% | 160 | $526.48 | |
| 90619 | <1% | 92 | $483.00 | |
| 90697 | <1% | 42 | $421.50 | |
| 90680 | <1% | 51 | $324.50 | |
| 90633 | <1% | 65 | $258.50 | |
| 90651 | <1% | 15 | $159.50 | |
| 91300 | 0% | 35 | $0.00 | |
| 91307 | 0% | 76 | $0.00 | |
| 90744 | 0% | 13 | $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 officialRISHI, FOUZIA (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Pediatric Urgent Care of Franklin County PC | Waynesboro, PA | $17K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.