Physician
Mousavilar, Shams
Mousavilar, Shams was paid $6K by Medicaid between Jan 2018 and Feb 2018, across 12 billing codes. Its largest line is 99394, Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) — 28% of everything it billed.
33Billing provider infoMOUSAVILAR, SHAMS
LA PUENTE, CA 91744
LA PUENTE, CA 91744
33aNPI1568400505assigned 06/03/2006
33bProvider typePediatrics Physician
28Total paid$6K
24GClaims863
24DCodes billed12
24AFirst – last monthJan 2018 – Feb 2018
Compared with peers
Next to other Pediatrics Physician providers in California
Rank by total paid#864 of 1,490
Median peer was paid$15K
This provider vs. median0.4×
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 | 863 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 28% | 45 | 45 | $2K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 26% | 56 | 56 | $2K |
| 92552 | 16% | 108 | 108 | $991.92 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 15% | 30 | 30 | $938.40 |
| 90472 | Immunization administration, each additional vaccine (list separately) | 6.2% | 99 | 64 | $392.30 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 6.0% | 103 | 103 | $381.04 |
| 99173 | 2.8% | 69 | 69 | $175.16 | |
| 92015 | Determination of refractive state | <1% | 36 | 36 | $7.19 |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 0% | 281 | 253 | $0.00 |
| 90686 | 0% | 12 | 12 | $0.00 | |
| 90716 | 0% | 12 | 12 | $0.00 | |
| 90707 | 0% | 12 | 12 | $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.