Physician
Childen's Community Care
Childen's Community Care was paid $177K by Medicaid between Dec 2018 and Dec 2024, across 13 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 70% of everything it billed.
33Billing provider infoCHILDEN'S COMMUNITY CARE
GROVE CITY, PA 16127
GROVE CITY, PA 16127
33aNPI1619495926assigned 09/07/2017
33bProvider typePediatrics Physician
28Total paid$177K
24GClaims2,540
24DCodes billed13
24AFirst – last monthDec 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#368 of 1,257
Median peer was paid$45K
This provider vs. median3.9×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MARTINEZ, LORI controls 20+ related entities in our dataset. Read more
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 | 15 | $1K | |
| 2019 | 127 | $5K | |
| 2020 | 84 | $7K | |
| 2021 | 369 | $32K | |
| 2022 | 612 | $47K | |
| 2023 | 627 | $39K | |
| 2024incomplete | 706 | $46K |
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 | 70% | 1,453 | 1,265 | $125K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 17% | 564 | 512 | $30K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.7% | 111 | 107 | $7K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.5% | 75 | 70 | $6K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.4% | 61 | 61 | $6K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 15 | 15 | $2K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 75 | 71 | $681.89 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 23 | 14 | $523.24 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 30 | 24 | $420.00 |
| 96127 | <1% | 34 | 33 | $102.78 | |
| 96160 | <1% | 33 | 33 | $84.68 | |
| 92551 | <1% | 52 | 52 | $51.20 |
1 more codes
| 99173 | 0% | 14 | $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 officialMARTINEZ, LORI (EXECUTIVE ADMINISTRATOR III)
| Provider | Location | Paid |
|---|---|---|
| Children's Community Care | Wexford, PA | $5.17M |
| Children's Community Care | Sewickley, PA | $3.28M |
| Children's Community Care | Uniontown, PA | $1.02M |
| Children's Community Care | Pittsburgh, PA | $898K |
| Childen's Community Care | New Castle, PA | $646K |
| Children's Community Care | Monongahela, PA | $628K |
| Children's Community Care | Erie, PA | $580K |
| Childen's Community Care | Pittsburgh, PA | $535K |
| Childen's Community Care | Hummelstown, PA | $522K |
| Children's Community Care | York, PA | $500K |
| Children's Community Care | Huntingdon, PA | $470K |
| Children's Community Care | Wexford, PA | $467K |
| Childen's Community Care | Camp Hill, PA | $438K |
| Children's Community Care | Pittsburgh, PA | $414K |
| Children's Community Care | New Castle, PA | $394K |
| Childen's Community Care | Hermitage, PA | $276K |
| Children's Community Care | North Huntingdon, PA | $252K |
| Children's Community Care | Natrona Heights, PA | $207K |
| Children's Community Care | White Oak, PA | $181K |
| Children's Community Care | Shippensburg, PA | $175K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.