Physician
Edgewood Pediatric Clinic L.L.C.
Edgewood Pediatric Clinic L.L.C. was paid $1.36M by Medicaid between Jan 2018 and Sep 2024, across 29 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 40% of everything it billed.
33Billing provider infoEDGEWOOD PEDIATRIC CLINIC L.L.C.
EDGEWOOD, NM 87015
EDGEWOOD, NM 87015
33aNPI1699905927assigned 07/21/2009
33bProvider typePediatrics Physician
28Total paid$1.36M
24GClaims24,642
24DCodes billed29
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Pediatrics Physician providers in New Mexico
Rank by total paid#22 of 53
Median peer was paid$535K
This provider vs. median2.5×
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 | 3,730 | $173K | |
| 2019 | 4,714 | $212K | |
| 2020 | 4,251 | $209K | |
| 2021 | 3,614 | $193K | |
| 2022 | 3,327 | $191K | |
| 2023 | 3,146 | $211K | |
| 2024incomplete | 1,860 | $166K |
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 | 40% | 5,192 | 4,802 | $543K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 14% | 1,866 | 1,858 | $194K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 14% | 1,794 | 1,788 | $186K |
| 90461 | 8.4% | 2,584 | 2,565 | $115K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.2% | 802 | 802 | $85K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.2% | 3,761 | 3,725 | $84K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.2% | 1,005 | 964 | $71K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.2% | 415 | 415 | $43K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.3% | 1,074 | 1,053 | $18K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 580 | 577 | $13K |
| 90670 | <1% | 1,397 | 1,393 | $2K | |
| 90698 | <1% | 521 | 521 | $698.66 |
17 more codes
| 81002 | <1% | 233 | $695.62 | |
| 90681 | <1% | 599 | $552.15 | |
| 90744 | <1% | 246 | $199.46 | |
| 90633 | <1% | 350 | $145.61 | |
| 90686 | <1% | 269 | $142.41 | |
| 90648 | <1% | 418 | $79.46 | |
| 96160 | <1% | 12 | $56.36 | |
| 90688 | <1% | 626 | $42.50 | |
| 90723 | <1% | 325 | $32.65 | |
| 90672 | <1% | 273 | $2.59 | |
| 90697 | <1% | 178 | $0.71 | |
| 90677 | <1% | 37 | $0.36 | |
| 90680 | <1% | 31 | $0.29 | |
| 90734 | <1% | 17 | $0.15 | |
| 90619 | <1% | 13 | $0.12 | |
| 90715 | <1% | 12 | $0.11 | |
| 90649 | <1% | 12 | $0.09 |
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 officialGARNAND, SHARON (OWNER)