Clinic
Covenant Pediatrics, PLLC
Covenant Pediatrics, PLLC was paid $1.77M by Medicaid between Jan 2018 and Dec 2024, across 40 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 43% of everything it billed.
33Billing provider infoCOVENANT PEDIATRICS, PLLC
ATHENS, TN 37303
ATHENS, TN 37303
33aNPI1659670412assigned 03/19/2011
33bProvider typeRural Health Clinic/Center
28Total paid$1.77M
24GClaims50,817
24DCodes billed40
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Tennessee
Rank by total paid#13 of 96
Median peer was paid$127K
This provider vs. median14×
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 | 14,322 | $387K | |
| 2019 | 10,935 | $357K | |
| 2020 | 5,489 | $199K | |
| 2021 | 4,980 | $215K | |
| 2022 | 4,462 | $197K | |
| 2023 | 5,197 | $212K | |
| 2024incomplete | 5,432 | $205K |
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 | 43% | 19,667 | 16,639 | $763K |
| 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 | 19% | 5,726 | 4,757 | $330K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 4,598 | 3,505 | $178K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 7.3% | 4,556 | 3,516 | $130K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.1% | 1,404 | 1,050 | $73K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.8% | 1,147 | 849 | $67K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.4% | 919 | 847 | $43K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.8% | 338 | 321 | $32K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.7% | 510 | 413 | $29K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.4% | 717 | 647 | $26K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.3% | 971 | 770 | $24K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.2% | 2,034 | 864 | $21K |
28 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,301 | $12K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 184 | $12K |
| 92551 | <1% | 882 | $5K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 544 | $5K |
| 96127 | <1% | 1,273 | $5K | |
| 96161 | <1% | 302 | $4K | |
| 92587 | <1% | 151 | $4K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 54 | $2K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 72 | $2K |
| 99173 | <1% | 383 | $2K | |
| 87807 | <1% | 189 | $2K | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 13 | $900.65 |
| 83655 | <1% | 97 | $865.47 | |
| 90670 | <1% | 692 | $730.58 | |
| 99177 | <1% | 104 | $485.71 | |
| 90686 | <1% | 304 | $445.03 | |
| 99462 | <1% | 14 | $343.48 | |
| 3008F | <1% | 174 | $260.00 | |
| 90698 | <1% | 237 | $127.31 | |
| 36416 | <1% | 90 | $103.85 | |
| 90685 | <1% | 354 | $47.63 | |
| 90633 | <1% | 60 | $42.42 | |
| 90688 | <1% | 303 | $41.70 | |
| 90744 | <1% | 180 | $23.18 | |
| 81002 | <1% | 18 | $23.08 | |
| 90756 | <1% | 65 | $0.21 | |
| 90680 | 0% | 165 | $0.00 | |
| 90651 | 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 officialBREEDEN, OMER (BUSINESS MANAGER)