Physician
Central Coast Pediatrics INC
Central Coast Pediatrics INC was paid $5.47M by Medicaid between Jan 2018 and Nov 2024, across 50 billing codes. Its largest line is 99392, Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) — 19% of everything it billed.
33Billing provider infoCENTRAL COAST PEDIATRICS INC
SAN LUIS OBISPO, CA 93401
SAN LUIS OBISPO, CA 93401
33aNPI1770517724assigned 07/10/2006
33bProvider typePediatrics Physician
28Total paid$5.47M
24GClaims121,062
24DCodes billed50
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in California
Rank by total paid#29 of 1,490
Median peer was paid$15K
This provider vs. median365×
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 | 18,274 | $366K | |
| 2019 | 18,265 | $664K | |
| 2020 | 13,914 | $776K | |
| 2021 | 15,765 | $1.01M | |
| 2022 | 19,951 | $1.36M | |
| 2023 | 21,847 | $828K | |
| 2024incomplete | 13,046 | $471K |
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) | 19% | 11,132 | 10,762 | $1.02M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 17% | 23,753 | 22,292 | $928K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 17% | 10,584 | 9,842 | $912K |
| 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% | 17,412 | 16,362 | $887K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 11% | 6,072 | 6,057 | $596K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.9% | 2,408 | 2,407 | $269K |
| 90670 | 3.1% | 6,129 | 5,790 | $168K | |
| 90686 | 2.7% | 7,277 | 7,172 | $149K | |
| 90698 | 1.5% | 3,809 | 3,531 | $82K | |
| 90680 | 1.1% | 2,968 | 2,726 | $61K | |
| G9920 | Screening performed and negative | 1.1% | 4,057 | 4,004 | $60K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.1% | 722 | 673 | $58K |
38 more codes
| 90710 | <1% | 1,074 | $37K | |
| 90744 | <1% | 1,946 | $36K | |
| 99173 | <1% | 8,555 | $27K | |
| 90633 | <1% | 1,350 | $26K | |
| 90700 | <1% | 1,152 | $21K | |
| 90677 | <1% | 750 | $17K | |
| 90651 | <1% | 351 | $14K | |
| 92551 | <1% | 1,063 | $13K | |
| 83655 | <1% | 955 | $12K | |
| 90656 | <1% | 479 | $12K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 346 | $12K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 197 | $10K |
| 96127 | <1% | 1,029 | $6K | |
| 90713 | <1% | 272 | $5K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,569 | $4K |
| 85018 | <1% | 1,599 | $4K | |
| 90619 | <1% | 148 | $4K | |
| 90696 | <1% | 123 | $4K | |
| 0071A | <1% | 87 | $3K | |
| 0072A | <1% | 59 | $2K | |
| 90734 | <1% | 92 | $2K | |
| 99460 | <1% | 37 | $2K | |
| 90685 | <1% | 201 | $2K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 87 | $1K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 100 | $1K |
| 99051 | <1% | 18 | $1K | |
| 90688 | <1% | 120 | $1K | |
| 90715 | <1% | 44 | $997.20 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 15 | $960.83 |
| 90648 | <1% | 81 | $954.14 | |
| 99462 | <1% | 28 | $856.54 | |
| 0154A | <1% | 13 | $520.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 38 | $451.79 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 13 | $444.74 |
| 81002 | <1% | 232 | $233.03 | |
| 90461 | <1% | 491 | $188.21 | |
| 87807 | <1% | 12 | $121.07 | |
| 91300 | 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 officialMACIAS, RICHARD (PRESIDENT/CFO)