Physician
Rainbow Enterprise PLC
Rainbow Enterprise PLC was paid $12.84M by Medicaid between Jan 2018 and Dec 2024, across 89 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.
33Billing provider infoRAINBOW ENTERPRISE PLC
CLARKSVILLE, TN 37043
CLARKSVILLE, TN 37043
33aNPI1609123884assigned 08/07/2012
33bProvider typePediatrics Physician
28Total paid$12.84M
24GClaims467,572
24DCodes billed89
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Tennessee
Rank by total paid#7 of 333
Median peer was paid$139K
This provider vs. median92×
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 | 42,902 | $1.26M | |
| 2019 | 63,412 | $1.71M | |
| 2020 | 57,727 | $1.40M | |
| 2021 | 64,428 | $1.89M | |
| 2022 | 71,775 | $2.09M | |
| 2023 | 88,913 | $2.28M | |
| 2024incomplete | 78,415 | $2.21M |
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 | 24% | 69,985 | 60,552 | $3.11M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 13% | 34,607 | 29,706 | $1.62M |
| 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 | 11% | 20,312 | 17,971 | $1.38M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10.0% | 16,533 | 14,727 | $1.28M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.9% | 16,002 | 14,138 | $1.14M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.2% | 10,466 | 9,104 | $799K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 6.0% | 34,861 | 30,629 | $766K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 4.0% | 7,516 | 6,791 | $509K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.3% | 5,193 | 4,217 | $422K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.8% | 7,390 | 6,827 | $354K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.6% | 7,595 | 6,678 | $204K |
| 96127 | 1.1% | 29,483 | 24,543 | $139K |
77 more codes
| 96160 | <1% | 10,545 | $116K | |
| 99381 | <1% | 1,344 | $105K | |
| 92551 | <1% | 13,450 | $100K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 900 | $84K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 1,779 | $58K |
| 96161 | <1% | 6,223 | $57K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 4,717 | $52K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 4,222 | $48K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,493 | $44K |
| 3008F | <1% | 32,944 | $43K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,851 | $39K |
| 99383 | <1% | 481 | $39K | |
| 99173 | <1% | 7,690 | $35K | |
| 83655 | <1% | 3,271 | $34K | |
| 99460 | <1% | 617 | $33K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 539 | $28K |
| 85018 | <1% | 11,416 | $23K | |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | <1% | 82 | $23K |
| 36416 | <1% | 14,253 | $16K | |
| 90670 | <1% | 9,649 | $14K | |
| 99177 | <1% | 2,115 | $13K | |
| 99382 | <1% | 155 | $12K | |
| 90461 | <1% | 22,251 | $11K | |
| 54150 | <1% | 66 | $10K | |
| 90651 | <1% | 1,519 | $9K | |
| 90698 | <1% | 12,515 | $8K | |
| 90677 | <1% | 2,752 | $5K | |
| 95117 | <1% | 326 | $5K | |
| 90686 | <1% | 6,616 | $4K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 55 | $4K |
| 90680 | <1% | 7,660 | $4K | |
| 87807 | <1% | 400 | $3K | |
| 87634 | <1% | 74 | $3K | |
| 99384 | <1% | 24 | $3K | |
| 99462 | <1% | 84 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 154 | $2K |
| 96380 | <1% | 123 | $2K | |
| 99051 | <1% | 602 | $2K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 16 | $2K |
| 90710 | <1% | 403 | $2K | |
| 95115 | <1% | 202 | $2K | |
| 90674 | <1% | 519 | $2K | |
| 82465 | <1% | 1,172 | $2K | |
| 90734 | <1% | 856 | $2K | |
| 90633 | <1% | 5,129 | $2K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 104 | $1K |
| 99417 | Prolong home eval add 15m | <1% | 40 | $1K |
| 69210 | <1% | 45 | $1K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 93 | $996.67 |
| 90744 | <1% | 5,447 | $848.60 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 66 | $762.45 |
| 0071A | <1% | 15 | $600.00 | |
| 90716 | <1% | 951 | $600.00 | |
| 90696 | <1% | 419 | $594.09 | |
| 90380 | <1% | 28 | $571.73 | |
| 81003 | <1% | 288 | $545.92 | |
| 90619 | <1% | 424 | $525.00 | |
| 99050 | <1% | 33 | $508.81 | |
| 0072A | <1% | 12 | $480.00 | |
| 94664 | <1% | 33 | $421.39 | |
| 90707 | <1% | 935 | $378.40 | |
| 99401 | <1% | 19 | $361.14 | |
| 90715 | <1% | 287 | $175.93 | |
| 90656 | <1% | 385 | $147.95 | |
| 92558 | <1% | 35 | $118.83 | |
| 94760 | <1% | 72 | $46.80 | |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 95 | $31.67 |
| 99000 | <1% | 2,570 | $9.13 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 94 | $9.05 |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | <1% | 12 | $0.92 |
| 90621 | 0% | 103 | $0.00 | |
| 90685 | 0% | 310 | $0.00 | |
| 90661 | 0% | 306 | $0.00 | |
| 5250F | 0% | 16 | $0.00 | |
| 90381 | 0% | 49 | $0.00 | |
| 91307 | 0% | 76 | $0.00 | |
| 91305 | 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 officialPRABHU, SATISH (OWNER)