Clinic
Pediatric Associates Prof LLC
Pediatric Associates Prof LLC was paid $7.03M by Medicaid between Jan 2018 and Dec 2024, across 63 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 40% of everything it billed.
33Billing provider infoPEDIATRIC ASSOCIATES PROF LLC
MONTROSE, CO 81401
MONTROSE, CO 81401
33aNPI1548261324assigned 08/03/2005
33bProvider typeRural Health Clinic/Center
28Total paid$7.03M
24GClaims128,243
24DCodes billed63
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Colorado
Rank by total paid#4 of 45
Median peer was paid$716K
This provider vs. median9.8×
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 | 25,541 | $1.07M | |
| 2019 | 18,885 | $1.03M | |
| 2020 | 16,482 | $896K | |
| 2021 | 18,085 | $1.04M | |
| 2022 | 16,915 | $1.16M | |
| 2023 | 18,435 | $1.08M | |
| 2024incomplete | 13,900 | $760K |
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 | 40% | 38,702 | 35,963 | $2.81M |
| 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 | 16% | 10,592 | 9,896 | $1.11M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 9.1% | 6,988 | 6,704 | $641K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.6% | 5,117 | 4,996 | $531K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.4% | 4,291 | 4,171 | $453K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.2% | 10,579 | 10,203 | $224K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.7% | 4,193 | 4,048 | $192K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 2.6% | 1,724 | 1,166 | $183K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.9% | 8,483 | 8,315 | $131K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1.7% | 834 | 801 | $120K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.6% | 4,776 | 4,670 | $115K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.6% | 955 | 930 | $110K |
51 more codes
| 99177 | 1.6% | 9,014 | $109K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 431 | $61K |
| 92552 | <1% | 2,209 | $58K | |
| 92551 | <1% | 3,934 | $47K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 887 | $34K |
| 90686 | <1% | 3,270 | $14K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 236 | $10K |
| 96127 | <1% | 1,195 | $8K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 110 | $8K |
| 99000 | <1% | 2,674 | $7K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 658 | $7K |
| 90670 | <1% | 431 | $6K | |
| 90461 | <1% | 1,360 | $5K | |
| 90473 | <1% | 205 | $4K | |
| 36416 | <1% | 1,538 | $4K | |
| 0071A | <1% | 63 | $3K | |
| 0072A | <1% | 47 | $3K | |
| 0001A | <1% | 83 | $3K | |
| 0002A | <1% | 56 | $2K | |
| 83655 | <1% | 155 | $2K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 136 | $2K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 79 | $2K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 41 | $1K |
| 99174 | <1% | 73 | $1K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 13 | $1K |
| 0111A | <1% | 39 | $822.19 | |
| 90734 | <1% | 13 | $484.71 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 27 | $446.31 |
| 85018 | <1% | 162 | $439.90 | |
| 90723 | <1% | 171 | $384.00 | |
| D1206 | Topical application of fluoride varnish | <1% | 24 | $380.84 |
| 90647 | <1% | 175 | $313.30 | |
| 90681 | <1% | 14 | $298.64 | |
| 90672 | <1% | 71 | $247.86 | |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable | <1% | 138 | $200.34 |
| 95117 | <1% | 14 | $177.76 | |
| 90633 | <1% | 26 | $124.11 | |
| 96160 | <1% | 23 | $106.40 | |
| 94760 | <1% | 42 | $83.64 | |
| 81003 | <1% | 37 | $73.50 | |
| 90715 | <1% | 12 | $51.82 | |
| 92558 | <1% | 13 | $15.16 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 140 | $8.67 |
| 91307 | 0% | 161 | $0.00 | |
| 90697 | 0% | 64 | $0.00 | |
| 90677 | 0% | 148 | $0.00 | |
| 90656 | 0% | 274 | $0.00 | |
| 90680 | 0% | 26 | $0.00 | |
| 91300 | 0% | 203 | $0.00 | |
| 90671 | 0% | 58 | $0.00 | |
| 91311 | 0% | 36 | $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 officialWIARD, THOMAS (MANAGING/PARTNER)