Behavioral
Children's Medical Group, LLC
Children's Medical Group, LLC was paid $2.58M by Medicaid between Jan 2018 and Dec 2024, across 41 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 33% of everything it billed.
33Billing provider infoCHILDREN'S MEDICAL GROUP, LLC
HAMDEN, CT 06518
HAMDEN, CT 06518
33aNPI1588603997assigned 06/05/2006
33bProvider typeClinical Social Worker
28Total paid$2.58M
24GClaims56,684
24DCodes billed41
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Social Worker providers in Connecticut
Rank by total paid#7 of 647
Median peer was paid$67K
This provider vs. median38×
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 | 8,232 | $366K | |
| 2019 | 8,532 | $383K | |
| 2020 | 7,408 | $296K | |
| 2021 | 8,348 | $352K | |
| 2022 | 8,951 | $425K | |
| 2023 | 7,667 | $360K | |
| 2024incomplete | 7,546 | $398K |
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 | 33% | 11,556 | 10,669 | $847K |
| 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 | 24% | 5,743 | 5,222 | $608K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 8,499 | 8,049 | $278K |
| 96160 | 8.3% | 11,696 | 10,863 | $215K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.4% | 1,186 | 1,141 | $166K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.5% | 980 | 930 | $117K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.9% | 2,525 | 2,345 | $101K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.6% | 546 | 508 | $68K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.0% | 446 | 418 | $51K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.3% | 766 | 683 | $34K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.1% | 1,189 | 1,145 | $27K |
| 96127 | <1% | 516 | 450 | $10K |
29 more codes
| 99051 | <1% | 1,361 | $9K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 935 | $9K |
| 92552 | <1% | 653 | $7K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 418 | $7K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 167 | $4K |
| 99173 | <1% | 568 | $4K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 93 | $3K |
| 96161 | <1% | 118 | $2K | |
| 99174 | <1% | 134 | $2K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 15 | $2K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 14 | $2K |
| 90686 | <1% | 4,591 | $2K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 53 | $1K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 15 | $1K |
| 94010 | <1% | 57 | $952.07 | |
| 36416 | <1% | 294 | $908.41 | |
| 99188 | <1% | 39 | $771.12 | |
| D1206 | Topical application of fluoride varnish | <1% | 12 | $297.60 |
| 90656 | <1% | 466 | $245.85 | |
| 83655 | <1% | 14 | $150.28 | |
| 85018 | <1% | 262 | $6.78 | |
| 90670 | 0% | 206 | $0.00 | |
| 90633 | 0% | 30 | $0.00 | |
| 90734 | 0% | 15 | $0.00 | |
| 90744 | 0% | 14 | $0.00 | |
| 90698 | 0% | 161 | $0.00 | |
| 99000 | 0% | 136 | $0.00 | |
| 90680 | 0% | 30 | $0.00 | |
| G0136 | Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months | 0% | 165 | $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 officialSUMMERS, CRAIG (PEDIATRICIAN)