Physician
Sumner Pediatrics, PLLC
Sumner Pediatrics, PLLC was paid $391K by Medicaid between Jan 2018 and Nov 2023, across 29 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 30% of everything it billed.
33Billing provider infoSUMNER PEDIATRICS, PLLC
HENDERSONVILLE, TN 37075
HENDERSONVILLE, TN 37075
33aNPI1639490246assigned 06/17/2010
33bProvider typePediatrics Physician
28Total paid$391K
24GClaims21,517
24DCodes billed29
24AFirst – last monthJan 2018 – Nov 2023
Compared with peers
Next to other Pediatrics Physician providers in Tennessee
Rank by total paid#123 of 333
Median peer was paid$139K
This provider vs. median2.8×
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 | 4,229 | $67K | |
| 2019 | 5,152 | $96K | |
| 2020 | 4,281 | $75K | |
| 2021 | 2,761 | $44K | |
| 2022 | 2,285 | $49K | |
| 2023 | 2,809 | $59K |
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% | 2,892 | 2,309 | $117K |
| 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 | 29% | 1,936 | 1,523 | $115K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 16% | 2,076 | 1,586 | $63K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 6.8% | 2,304 | 1,856 | $27K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.5% | 221 | 168 | $14K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.2% | 201 | 160 | $13K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.6% | 389 | 332 | $10K |
| 92551 | 2.3% | 1,515 | 1,192 | $9K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.3% | 685 | 550 | $5K |
| 96127 | <1% | 941 | 738 | $4K | |
| 96160 | <1% | 1,987 | 1,588 | $3K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 33 | 26 | $3K |
17 more codes
| 99173 | <1% | 1,516 | $2K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 43 | $2K |
| 3008F | <1% | 1,545 | $2K | |
| 99402 | <1% | 196 | $2K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 483 | $780.47 |
| 90686 | <1% | 588 | $550.87 | |
| 90461 | <1% | 415 | $230.34 | |
| 99174 | <1% | 20 | $131.11 | |
| 94760 | <1% | 198 | $26.52 | |
| 96161 | <1% | 16 | $2.68 | |
| 99072 | 0% | 94 | $0.00 | |
| 90633 | 0% | 13 | $0.00 | |
| 90734 | 0% | 15 | $0.00 | |
| S8301 | Infection control supplies, not otherwise specified | 0% | 30 | $0.00 |
| 99000 | 0% | 1,117 | $0.00 | |
| 90688 | 0% | 24 | $0.00 | |
| 99070 | 0% | 24 | $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 officialBENITEZ-BRAUER, MARIA CORAZON (MD/OWNER)