Pediatric Health Care Alliance, PA

Pediatric Health Care Alliance, PA was paid $12.31M by Medicaid between Jan 2018 and Dec 2024, across 59 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.

33Billing provider infoPEDIATRIC HEALTH CARE ALLIANCE, PA
OLDSMAR, FL 34677

33aNPI1609965441assigned 10/12/2006

33bProvider typeBehavioral Analyst

28Total paid$12.31M

24GClaims556,740

24DCodes billed59

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Behavioral Analyst providers in Florida

Rank by total paid#10 of 631

Median peer was paid$148K

This provider vs. median83×

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	2,729	$182K
2019	25,520	$1.10M
2020	34,158	$1.14M
2021	94,658	$2.38M
2022	252,042	$2.61M
2023	73,253	$3.24M
2024incomplete	74,380	$1.66M

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	37%	83,917	59,779	$4.59M
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	28%	42,975	30,166	$3.49M
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	8.5%	13,038	9,140	$1.05M
90460	Immunization administration through 18 years of age via any route, first or only component	7.2%	55,422	39,406	$889K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	4.9%	10,082	6,370	$598K
87428		3.8%	17,036	9,421	$466K
90461		3.4%	17,216	10,933	$422K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.5%	3,880	2,994	$305K
99072		1.2%	136,180	63,678	$143K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	<1%	869	474	$67K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	645	515	$60K
99051		<1%	2,480	1,661	$26K

47 more codes

90686		<1%	7,878	$25K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	3,216	$21K
99188		<1%	3,315	$20K
99000		<1%	14,296	$20K
94760		<1%	15,940	$18K
92551		<1%	18,046	$12K
97802		<1%	26,684	$11K
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	<1%	26,862	$10K
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%	12,599	$9K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	1,221	$7K
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	<1%	816	$5K
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	1,895	$4K
96112		<1%	43	$4K
87807		<1%	575	$4K
96161		<1%	1,675	$4K
36416		<1%	10,660	$4K
99173		<1%	9,275	$4K
85018		<1%	3,158	$3K
96127		<1%	2,433	$3K
90677		<1%	758	$3K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	39	$2K
99177		<1%	816	$1K
96113		<1%	46	$1K
90670		<1%	3,447	$1K
90671		<1%	231	$973.08
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	189	$912.45
0071A		<1%	43	$855.30
G2212	Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)	<1%	24	$718.74
90698		<1%	2,250	$578.31
81003		<1%	1,008	$474.93
0002A		<1%	12	$473.28
0001A		<1%	14	$436.20
83718		<1%	128	$118.05
90656		<1%	212	$108.13
82465		<1%	128	$107.39
91307		<1%	46	$78.57
90660		<1%	19	$72.03
90680		<1%	1,592	$55.75
36415	Collection of venous blood by venipuncture	<1%	28	$55.00
90744		<1%	442	$48.02
90672		<1%	35	$20.00
90633		<1%	415	$10.00
90734		0%	37	$0.00
90715		0%	30	$0.00
90651		0%	184	$0.00
99417	Prolong home eval add 15m	0%	215	$0.00
90619		0%	25	$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 officialGONZALEZ, DEBRA (CHIEF ADMINISTRATIVE OFFICER)