Physician
Carlos, Imelda
Carlos, Imelda was paid $531K by Medicaid between Jan 2018 and Jun 2022, across 28 billing codes. Its largest line is 99392, Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) — 20% of everything it billed.
33Billing provider infoCARLOS, IMELDA
CAROL STREAM, IL 60188
CAROL STREAM, IL 60188
33aNPI1699864124assigned 10/12/2006
33bProvider typePediatrics Physician
28Total paid$531K
24GClaims15,791
24DCodes billed28
24AFirst – last monthJan 2018 – Jun 2022
Compared with peers
Next to other Pediatrics Physician providers in Illinois
Rank by total paid#282 of 1,805
Median peer was paid$55K
This provider vs. median9.6×
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 | 4,131 | $114K | |
| 2019 | 4,501 | $160K | |
| 2020 | 2,497 | $91K | |
| 2021 | 3,256 | $114K | |
| 2022 | 1,406 | $53K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 20% | 1,420 | 1,058 | $106K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 18% | 2,078 | 1,700 | $96K |
| 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 | 16% | 1,163 | 1,012 | $85K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 16% | 1,235 | 914 | $83K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 13% | 2,478 | 1,982 | $67K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.4% | 310 | 288 | $23K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.7% | 789 | 688 | $20K |
| 90670 | 2.3% | 742 | 568 | $12K | |
| 99173 | 1.4% | 979 | 813 | $7K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 367 | 322 | $6K |
| 90686 | <1% | 610 | 543 | $5K | |
| 90685 | <1% | 479 | 346 | $4K |
16 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 43 | $3K |
| 90723 | <1% | 379 | $3K | |
| 90647 | <1% | 396 | $3K | |
| 90680 | <1% | 310 | $3K | |
| 99460 | <1% | 40 | $2K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 27 | $1K |
| 0071A | <1% | 32 | $1K | |
| 90633 | <1% | 113 | $894.31 | |
| 96127 | <1% | 60 | $876.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,311 | $174.00 |
| 90696 | <1% | 19 | $121.60 | |
| 90710 | <1% | 19 | $121.60 | |
| 90651 | <1% | 17 | $108.80 | |
| 97802 | 0% | 113 | $0.00 | |
| 96161 | 0% | 62 | $0.00 | |
| 90461 | 0% | 200 | $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.