Physician
Cardinal Pediatrics PLLC
Cardinal Pediatrics PLLC was paid $11.13M by Medicaid between Jan 2018 and Dec 2024, across 96 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 28% of everything it billed.
33Billing provider infoCARDINAL PEDIATRICS PLLC
MORGANTOWN, WV 26505
MORGANTOWN, WV 26505
33aNPI1548272651assigned 08/13/2006
33bProvider typePediatrics Physician
28Total paid$11.13M
24GClaims384,255
24DCodes billed96
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in West Virginia
Rank by total paid#1 of 57
Median peer was paid$409K
This provider vs. median27×
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 | 23,711 | $1.04M | |
| 2019 | 14,603 | $571K | |
| 2020 | 42,863 | $1.27M | |
| 2021 | 53,884 | $1.52M | |
| 2022 | 88,920 | $2.35M | |
| 2023 | 84,595 | $2.28M | |
| 2024incomplete | 75,679 | $2.10M |
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 | 28% | 55,773 | 48,922 | $3.14M |
| 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 | 25% | 35,487 | 31,783 | $2.82M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.3% | 12,597 | 12,064 | $920K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.8% | 9,749 | 9,003 | $646K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.2% | 7,977 | 7,658 | $574K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 3.6% | 16,583 | 15,595 | $396K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.5% | 33,206 | 26,339 | $386K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.0% | 23,942 | 22,543 | $330K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.3% | 3,193 | 3,056 | $254K |
| 92551 | 1.6% | 18,182 | 17,332 | $183K | |
| 87428 | 1.3% | 4,123 | 3,812 | $146K | |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 1,136 | 775 | $111K |
84 more codes
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 2,831 | $97K |
| 99188 | <1% | 5,225 | $96K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 5,783 | $93K |
| 99173 | <1% | 17,823 | $80K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 5,138 | $78K |
| 99381 | <1% | 940 | $66K | |
| 94760 | <1% | 18,996 | $66K | |
| 99383 | <1% | 590 | $45K | |
| 90473 | <1% | 3,691 | $42K | |
| 90686 | <1% | 8,752 | $38K | |
| 96127 | <1% | 8,692 | $38K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 1,076 | $38K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 300 | $35K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 951 | $34K |
| 83655 | <1% | 2,901 | $34K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 277 | $33K |
| 87807 | <1% | 2,543 | $29K | |
| 96161 | <1% | 5,245 | $25K | |
| 99174 | <1% | 6,512 | $25K | |
| 99382 | <1% | 324 | $24K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,129 | $23K |
| 99384 | <1% | 218 | $19K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 204 | $15K |
| 90670 | <1% | 5,900 | $15K | |
| 90648 | <1% | 6,525 | $13K | |
| 83718 | <1% | 1,481 | $11K | |
| 96160 | <1% | 4,493 | $11K | |
| 96112 | <1% | 124 | $10K | |
| 0071A | <1% | 288 | $10K | |
| 0072A | <1% | 194 | $7K | |
| 85018 | <1% | 2,925 | $7K | |
| 82465 | <1% | 1,467 | $7K | |
| 36416 | <1% | 3,166 | $6K | |
| 90723 | <1% | 3,880 | $5K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 45 | $4K |
| 96113 | <1% | 63 | $4K | |
| 81002 | <1% | 1,948 | $4K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 580 | $4K |
| 81025 | <1% | 493 | $4K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 404 | $4K |
| 99401 | <1% | 65 | $3K | |
| 90633 | <1% | 3,567 | $3K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 49 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 196 | $3K |
| 96380 | <1% | 188 | $2K | |
| 0073A | <1% | 38 | $2K | |
| 0081A | <1% | 33 | $1K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 14 | $997.87 |
| 90698 | <1% | 50 | $966.12 | |
| 90681 | <1% | 1,983 | $920.20 | |
| 90651 | <1% | 1,897 | $835.46 | |
| 90734 | <1% | 1,663 | $817.06 | |
| 94664 | <1% | 77 | $786.90 | |
| 90710 | <1% | 3,269 | $595.57 | |
| 90680 | <1% | 965 | $547.13 | |
| 0154A | <1% | 18 | $526.00 | |
| 90672 | <1% | 631 | $509.47 | |
| 0111A | <1% | 14 | $486.00 | |
| 0112A | <1% | 13 | $486.00 | |
| 0001A | <1% | 13 | $480.00 | |
| 99072 | <1% | 3,566 | $468.67 | |
| 90715 | <1% | 1,137 | $324.97 | |
| 90656 | <1% | 1,003 | $211.77 | |
| 94761 | <1% | 69 | $137.12 | |
| 82947 | <1% | 44 | $103.44 | |
| 90685 | <1% | 16 | $94.32 | |
| 86308 | <1% | 14 | $62.08 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 64 | $46.77 |
| J8540 | Dexamethasone, oral, 0.25 mg | <1% | 66 | $0.18 |
| 90700 | 0% | 1,569 | $0.00 | |
| 90671 | 0% | 1,735 | $0.00 | |
| 91311 | 0% | 40 | $0.00 | |
| 91300 | 0% | 94 | $0.00 | |
| 99051 | 0% | 26 | $0.00 | |
| 91308 | 0% | 72 | $0.00 | |
| 90380 | 0% | 54 | $0.00 | |
| 90696 | 0% | 1,597 | $0.00 | |
| 90697 | 0% | 782 | $0.00 | |
| 90620 | 0% | 110 | $0.00 | |
| 99000 | 0% | 587 | $0.00 | |
| J7609 | Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg | 0% | 67 | $0.00 |
| 91307 | 0% | 642 | $0.00 | |
| 90381 | 0% | 80 | $0.00 | |
| 91315 | 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 officialMCBRIDE, LISA (MD/MEMBER)