Physician
Pediatric Associates of Fall River, INC
Pediatric Associates of Fall River, INC was paid $9.42M by Medicaid between Jan 2018 and Dec 2024, across 53 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 30% of everything it billed.
33Billing provider infoPEDIATRIC ASSOCIATES OF FALL RIVER, INC
FALL RIVER, MA 02724
FALL RIVER, MA 02724
33aNPI1619930146assigned 04/07/2006
33bProvider typePediatrics Physician
28Total paid$9.42M
24GClaims299,411
24DCodes billed53
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Massachusetts
Rank by total paid#2 of 1,273
Median peer was paid$24K
This provider vs. median393×
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 | 41,318 | $1.46M | |
| 2019 | 42,710 | $1.59M | |
| 2020 | 36,381 | $1.22M | |
| 2021 | 41,098 | $1.57M | |
| 2022 | 48,766 | $2.11M | |
| 2023 | 47,853 | $998K | |
| 2024incomplete | 41,285 | $465K |
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 | 30% | 54,455 | 51,906 | $2.80M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.2% | 10,968 | 10,954 | $774K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.7% | 10,466 | 10,456 | $726K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.3% | 8,577 | 8,430 | $596K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.2% | 26,652 | 26,583 | $583K |
| 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 | 5.3% | 8,712 | 8,518 | $499K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.0% | 6,576 | 6,567 | $472K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 5.0% | 6,230 | 6,169 | $469K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 4.7% | 46,768 | 46,388 | $441K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 4.3% | 39,386 | 38,540 | $402K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 4.0% | 4,641 | 4,597 | $372K |
| 87634 | 3.1% | 4,659 | 4,615 | $291K |
41 more codes
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | 1.4% | 5,147 | $129K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.2% | 8,252 | $109K |
| 90461 | <1% | 6,110 | $94K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 4,362 | $75K |
| 83655 | <1% | 6,617 | $74K | |
| 99050 | <1% | 5,123 | $70K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 1,036 | $53K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,213 | $52K |
| 99188 | <1% | 1,836 | $49K | |
| 99173 | <1% | 3,758 | $49K | |
| 96127 | <1% | 5,864 | $47K | |
| 87081 | <1% | 5,671 | $35K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,390 | $30K |
| 85018 | <1% | 8,350 | $18K | |
| 92552 | <1% | 701 | $18K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 206 | $17K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 403 | $17K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 508 | $15K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 496 | $15K |
| 99401 | <1% | 411 | $9K | |
| 0072A | <1% | 81 | $4K | |
| 0071A | <1% | 64 | $3K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 21 | $3K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 43 | $2K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 39 | $1K |
| 83718 | <1% | 122 | $926.86 | |
| 94760 | <1% | 208 | $502.24 | |
| 82465 | <1% | 122 | $488.30 | |
| 87807 | <1% | 32 | $350.08 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 18 | $280.10 |
| 98966 | <1% | 18 | $193.86 | |
| 99174 | <1% | 307 | $167.70 | |
| 99441 | <1% | 12 | $129.24 | |
| 95117 | <1% | 16 | $94.10 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12 | $93.08 |
| 81003 | <1% | 26 | $56.68 | |
| 96160 | <1% | 118 | $8.56 | |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 16 | $2.21 |
| 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) | 0% | 130 | $0.00 |
| 99072 | 0% | 472 | $0.00 | |
| 36416 | 0% | 990 | $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 officialROK, WALTER (PRESIDENT)