Children's Community Care
Children's Community Care was paid $5.17M by Medicaid between Jan 2018 and Dec 2024, across 75 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 34% of everything it billed.
33Billing provider infoCHILDREN'S COMMUNITY CARE
WEXFORD, PA 15090
WEXFORD, PA 15090
33aNPI1659339547assigned 05/02/2006
33bProvider typeRegistered Dietitian
28Total paid$5.17M
24GClaims158,616
24DCodes billed75
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Registered Dietitian providers in Pennsylvania
Rank by total paid#4 of 46
Median peer was paid$19K
This provider vs. median269×
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 | 2,774 | $95K | |
| 2019 | 4,954 | $159K | |
| 2020 | 11,864 | $368K | |
| 2021 | 61,516 | $2.08M | |
| 2022 | 51,772 | $1.89M | |
| 2023 | 13,881 | $300K | |
| 2024incomplete | 11,855 | $277K |
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 | 34% | 24,339 | 22,194 | $1.76M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 28% | 31,053 | 28,555 | $1.43M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.4% | 6,090 | 5,977 | $437K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.4% | 4,523 | 4,417 | $332K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.2% | 4,274 | 4,159 | $268K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 2.5% | 2,696 | 2,233 | $130K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.1% | 2,021 | 1,936 | $110K |
| 99051 | 1.7% | 3,697 | 3,500 | $86K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.5% | 4,047 | 3,739 | $77K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.5% | 1,455 | 1,382 | $76K |
| 90686 | <1% | 8,355 | 7,591 | $39K | |
| 90670 | <1% | 6,105 | 5,972 | $38K |
63 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,912 | $36K |
| 90734 | <1% | 1,803 | $32K | |
| 90461 | <1% | 914 | $30K | |
| 90648 | <1% | 7,094 | $27K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 304 | $24K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 312 | $24K |
| 90723 | <1% | 5,328 | $21K | |
| 90651 | <1% | 2,556 | $21K | |
| 90680 | <1% | 4,649 | $19K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,191 | $17K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,572 | $15K |
| 90633 | <1% | 3,748 | $14K | |
| 90715 | <1% | 1,474 | $9K | |
| 90620 | <1% | 771 | $8K | |
| 90710 | <1% | 1,772 | $8K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 335 | $7K |
| 90696 | <1% | 1,678 | $6K | |
| 90700 | <1% | 1,723 | $6K | |
| 90716 | <1% | 1,680 | $6K | |
| 90707 | <1% | 1,632 | $6K | |
| 99188 | <1% | 321 | $6K | |
| 99242 | <1% | 65 | $6K | |
| 92551 | <1% | 3,187 | $4K | |
| 87428 | <1% | 308 | $4K | |
| 99381 | <1% | 69 | $3K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,101 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 62 | $3K |
| 99173 | <1% | 1,138 | $3K | |
| 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% | 136 | $2K |
| 99243 | <1% | 14 | $2K | |
| 99177 | <1% | 761 | $2K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 12 | $2K |
| 17110 | <1% | 69 | $1K | |
| 99383 | <1% | 12 | $1K | |
| 99384 | <1% | 12 | $1K | |
| 96127 | <1% | 1,254 | $716.40 | |
| 96161 | <1% | 935 | $502.44 | |
| 96160 | <1% | 1,269 | $415.46 | |
| 0001A | <1% | 34 | $351.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 16 | $330.00 |
| 90744 | <1% | 29 | $324.00 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 13 | $260.10 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 30 | $223.24 |
| 0071A | <1% | 421 | $177.00 | |
| 85018 | <1% | 94 | $176.79 | |
| 88720 | <1% | 19 | $126.55 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 450 | $121.56 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 346 | $7.18 |
| 36416 | <1% | 81 | $3.66 | |
| G9920 | Screening performed and negative | 0% | 223 | $0.00 |
| 90661 | 0% | 612 | $0.00 | |
| 0002A | 0% | 31 | $0.00 | |
| 83655 | 0% | 94 | $0.00 | |
| 91321 | 0% | 62 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 442 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 179 | $0.00 |
| 90619 | 0% | 759 | $0.00 | |
| 90677 | 0% | 1,242 | $0.00 | |
| 90656 | 0% | 166 | $0.00 | |
| 0072A | 0% | 384 | $0.00 | |
| 90381 | 0% | 25 | $0.00 | |
| 0112A | 0% | 12 | $0.00 | |
| 0111A | 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 officialMARTINEZ, LORI (EXECUTIVE ADMINISTRATOR III)
| Provider | Location | Paid |
|---|---|---|
| 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 |
| Childen's Community Care | Grove City, PA | $177K |
| 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.