Physician
Falcon, Carla
Falcon, Carla was paid $104K by Medicaid between Jan 2018 and Dec 2021, across 20 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 27% of everything it billed.
33Billing provider infoFALCON, CARLA
MONROEVILLE, PA 15146
MONROEVILLE, PA 15146
33aNPI1588667331assigned 05/24/2005
33bProvider typePediatrics Physician
28Total paid$104K
24GClaims2,387
24DCodes billed20
24AFirst – last monthJan 2018 – Dec 2021
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#479 of 1,257
Median peer was paid$45K
This provider vs. median2.3×
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 | 26 | $2K | |
| 2019 | 39 | $2K | |
| 2020 | 297 | $12K | |
| 2021 | 2,025 | $87K |
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 | 27% | 341 | 327 | $28K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 20% | 411 | 399 | $21K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 18% | 209 | 209 | $19K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 12% | 149 | 148 | $13K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.8% | 117 | 117 | $10K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.4% | 60 | 59 | $6K |
| 90686 | 1.8% | 166 | 164 | $2K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.7% | 42 | 41 | $2K |
| 87428 | 1.1% | 21 | 21 | $1K | |
| 90670 | <1% | 84 | 84 | $913.00 | |
| 90648 | <1% | 73 | 73 | $807.00 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 19 | 19 | $614.88 |
8 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 20 | $297.92 |
| 99173 | <1% | 159 | $275.00 | |
| 92551 | <1% | 186 | $78.00 | |
| 96160 | 0% | 103 | $0.00 | |
| 99177 | 0% | 27 | $0.00 | |
| 96127 | 0% | 103 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 69 | $0.00 |
| 96161 | 0% | 28 | $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.