Physician
Fox Pediatrics,plc
Fox Pediatrics,plc was paid $1.38M by Medicaid between Jan 2018 and Dec 2024, across 49 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 27% of everything it billed.
33Billing provider infoFOX PEDIATRICS,PLC
MOUNT PLEASANT, MI 48858
MOUNT PLEASANT, MI 48858
33aNPI1730564105assigned 07/27/2015
33bProvider typePediatrics Physician
28Total paid$1.38M
24GClaims41,373
24DCodes billed49
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Michigan
Rank by total paid#95 of 349
Median peer was paid$321K
This provider vs. median4.3×
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 | 3,665 | $118K | |
| 2019 | 4,736 | $134K | |
| 2020 | 4,398 | $133K | |
| 2021 | 6,842 | $218K | |
| 2022 | 7,579 | $241K | |
| 2023 | 7,551 | $278K | |
| 2024incomplete | 6,602 | $253K |
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 | 27% | 6,206 | 5,683 | $374K |
| 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% | 2,518 | 2,403 | $222K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 16% | 2,448 | 2,438 | $215K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 12% | 2,466 | 2,428 | $167K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 9.1% | 5,452 | 5,355 | $125K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.8% | 1,316 | 1,311 | $121K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.7% | 1,659 | 1,606 | $65K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.7% | 1,858 | 1,487 | $23K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.6% | 256 | 256 | $22K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 902 | 874 | $11K |
| 96127 | <1% | 2,056 | 1,540 | $5K | |
| 97803 | <1% | 2,413 | 2,405 | $4K |
37 more codes
| 92015 | Determination of refractive state | <1% | 336 | $4K |
| D0190 | <1% | 563 | $3K | |
| 99177 | <1% | 1,802 | $3K | |
| 36416 | <1% | 259 | $3K | |
| 99381 | <1% | 24 | $2K | |
| 99051 | <1% | 165 | $2K | |
| 83655 | <1% | 73 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 52 | $1K |
| 99188 | <1% | 125 | $843.35 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 60 | $510.47 |
| 36415 | Collection of venous blood by venipuncture | <1% | 69 | $488.46 |
| 97802 | <1% | 99 | $300.00 | |
| 94664 | <1% | 15 | $145.49 | |
| 99490 | Ccm add 20min | <1% | 13 | $80.08 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 31 | $58.14 |
| 85018 | <1% | 102 | $52.56 | |
| 90670 | 0% | 1,451 | $0.00 | |
| 90648 | 0% | 1,286 | $0.00 | |
| 90633 | 0% | 513 | $0.00 | |
| 90685 | 0% | 117 | $0.00 | |
| 90707 | 0% | 27 | $0.00 | |
| 90461 | 0% | 344 | $0.00 | |
| 90710 | 0% | 41 | $0.00 | |
| 90681 | 0% | 88 | $0.00 | |
| 90734 | 0% | 12 | $0.00 | |
| 90700 | 0% | 27 | $0.00 | |
| 90687 | 0% | 59 | $0.00 | |
| 90680 | 0% | 806 | $0.00 | |
| 90723 | 0% | 999 | $0.00 | |
| 90686 | 0% | 1,327 | $0.00 | |
| 90698 | 0% | 351 | $0.00 | |
| 90688 | 0% | 105 | $0.00 | |
| 90677 | 0% | 290 | $0.00 | |
| 90716 | 0% | 15 | $0.00 | |
| 90696 | 0% | 29 | $0.00 | |
| 90656 | 0% | 135 | $0.00 | |
| 90651 | 0% | 13 | $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 officialFOX, CONSTANZA (OWNER)