Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Children's Hospital

Children's Hospital was paid $115.27M by Medicaid between Jan 2018 and Dec 2024, across 292 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 14% of everything it billed.

33Billing provider infoCHILDREN'S HOSPITAL
WASHINGTON, DC 20010
33aNPI1780800128assigned 04/17/2007
33bProvider typePediatrics Physician
28Total paid$115.27M
24GClaims1,906,386
24DCodes billed292
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Pediatrics Physician providers in District of Columbia

Rank by total paid#1 of 33
Median peer was paid$6K
This provider vs. median20,134×

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

$0$1.0M$2.0M$3.0M2018201920202021202220232024
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
YearClaimsPaid
2018205,693$10.59M
2019202,631$9.69M
2020233,412$13.74M
2021310,796$18.76M
2022327,549$20.41M
2023329,140$22.22M
2024incomplete297,165$19.85M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 14% 264,371 251,236 $16.19M
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 11% 140,880 133,632 $12.62M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 9.4% 177,574 171,031 $10.89M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 9.1% 102,055 97,282 $10.48M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 7.1% 65,976 60,746 $8.23M
99472 Subsequent inpatient pediatric critical care, per day, 2-5 years 5.6% 21,424 5,434 $6.50M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 5.0% 66,544 25,965 $5.79M
99244 Office or other outpatient consultation, moderate to high complexity 2.4% 19,396 18,502 $2.78M
99204 Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2.4% 20,795 19,959 $2.73M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 2.3% 13,686 5,451 $2.70M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1.8% 32,750 31,483 $2.10M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1.7% 31,696 30,438 $2.02M
280 more codes
99285 Emergency room visit (most serious) 1.7% 13,364 $1.92M
99243 1.5% 19,380 $1.76M
99203 Doctor's office visit, new patient (routine) 1.4% 19,775 $1.64M
T2022 Case management, per month <1% 5,444 $1.04M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 18,106 $1.01M
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 23,437 $991K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study <1% 19,353 $974K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 42,151 $895K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 12,108 $826K
99238 Hospital discharge day management, 30 minutes or less <1% 13,839 $763K
70551 Magnetic resonance imaging, brain; without contrast material <1% 9,884 $720K
99460 <1% 8,783 $718K
95720 <1% 4,465 $713K
99245 <1% 4,101 $691K
99205 Prolong outpt/office vis <1% 4,241 $668K
99480 Subsequent intensive care, per day, low birth weight infant <1% 7,276 $665K
99232 Hospital visit by a doctor, follow-up day <1% 10,561 $632K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 2,547 $596K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 4,222 $560K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 7,888 $539K
99223 Prolong inpt eval add15 m <1% 3,079 $539K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 15,051 $525K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 6,107 $440K
70450 Computed tomography, head or brain; without contrast material <1% 10,792 $413K
71045 Radiologic examination, chest; single view <1% 66,997 $378K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 14,365 $374K
93320 <1% 20,918 $344K
71046 Radiologic examination, chest; 2 views <1% 38,249 $331K
90791 Psychiatric diagnostic evaluation <1% 2,641 $321K
90834 Psychotherapy session, about 45 minutes <1% 4,241 $311K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 49,353 $307K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 12,415 $286K
90461 <1% 11,811 $269K
99254 <1% 1,963 $262K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 3,620 $251K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger <1% 823 $239K
76770 <1% 8,273 $235K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 2,125 $229K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 1,163 $214K
90837 Psychotherapy session, about an hour <1% 1,909 $214K
01922 <1% 1,026 $213K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 4,200 $207K
92015 Determination of refractive state <1% 15,113 $206K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 3,292 $197K
99239 Hospital discharge day management, more than 30 minutes <1% 2,829 $188K
00170 Anesthesia for intraoral procedures, including biopsy <1% 1,201 $186K
96127 <1% 64,657 $182K
92551 <1% 19,233 $178K
99288 <1% 4,720 $173K
90832 Psychotherapy session, about 30 minutes <1% 2,571 $154K
99471 <1% 207 $153K
92060 <1% 5,065 $149K
93325 <1% 31,209 $145K
99462 <1% 3,860 $143K
99242 <1% 2,070 $143K
90847 Family psychotherapy with the patient present, 50 minutes <1% 1,659 $137K
96112 <1% 1,259 $132K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 12,530 $132K
95951 <1% 535 $117K
95782 <1% 1,040 $112K
99220 <1% 679 $110K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 8,499 $109K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 3,195 $101K
99417 Prolong home eval add 15m <1% 2,874 $99K
90839 <1% 1,183 $94K
74022 <1% 9,312 $92K
96156 <1% 1,766 $91K
74018 <1% 13,916 $91K
96113 <1% 633 $89K
99255 <1% 566 $86K
90670 <1% 1,102 $81K
76825 <1% 1,233 $78K
54150 <1% 1,029 $78K
74021 <1% 7,391 $75K
D2930 Prefabricated stainless steel crown - primary tooth <1% 251 $75K
94010 <1% 10,018 $75K
99476 <1% 235 $73K
99174 <1% 14,715 $68K
90686 <1% 5,996 $65K
D0191 <1% 3,297 $62K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 1,128 $58K
90472 Immunization administration, each additional vaccine (list separately) <1% 4,282 $58K
D1120 Dental cleaning, child <1% 1,215 $57K
99173 <1% 23,606 $57K
99222 Initial hospital care, per day, moderate complexity <1% 437 $53K
95718 <1% 502 $52K
D7140 Extraction, erupted tooth or exposed root <1% 476 $52K
80502 <1% 1,123 $50K
90651 <1% 377 $46K
88108 <1% 2,887 $45K
73610 <1% 6,466 $45K
16020 <1% 1,056 $44K
99479 Subsequent intensive care, per day, very low birth weight infant <1% 460 $44K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 820 $43K
99464 <1% 834 $43K
99253 <1% 446 $42K
73090 <1% 6,666 $42K
76506 <1% 1,883 $42K
73590 <1% 6,327 $40K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 3,580 $40K
88307 <1% 620 $38K
D0120 Dental checkup, returning patient <1% 1,066 $37K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 425 $37K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 1,619 $36K
D1206 Topical application of fluoride varnish <1% 1,243 $36K
0071A <1% 971 $35K
99236 Prolong inpt eval add15 m <1% 179 $34K
76000 <1% 2,413 $33K
80503 <1% 2,020 $32K
95819 <1% 724 $32K
0072A <1% 789 $30K
73630 <1% 4,386 $30K
93976 <1% 792 $30K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 1,001 $30K
95251 <1% 996 $30K
72081 <1% 3,009 $29K
88300 <1% 6,600 $29K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 244 $29K
93000 <1% 2,074 $28K
90677 <1% 338 $28K
90698 <1% 825 $27K
76827 <1% 1,233 $27K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis <1% 578 $26K
88304 <1% 2,372 $26K
88188 <1% 579 $24K
D0150 Comprehensive oral evaluation - new or established patient <1% 284 $21K
90710 <1% 170 $21K
73080 <1% 3,125 $21K
D0140 Limited oral evaluation - problem focused <1% 396 $20K
96167 <1% 845 $19K
72170 <1% 2,716 $19K
96116 <1% 117 $18K
77072 <1% 2,643 $18K
92201 <1% 1,015 $16K
D0272 Bitewings - two radiographic images <1% 404 $16K
69210 <1% 631 $16K
90792 Psychiatric diagnostic evaluation with medical services <1% 123 $16K
99188 <1% 1,679 $16K
99292 <1% 173 $15K
88342 <1% 584 $15K
43775 <1% 18 $15K
85060 <1% 1,118 $15K
76536 <1% 674 $15K
73130 <1% 2,027 $14K
73100 <1% 2,356 $14K
90734 <1% 164 $13K
31575 <1% 251 $13K
70486 <1% 298 $12K
D1351 Sealant - per tooth <1% 318 $12K
73140 <1% 2,164 $12K
94060 <1% 1,064 $12K
77001 <1% 511 $11K
90716 <1% 104 $11K
0001A <1% 348 $11K
72082 <1% 920 $10K
90633 <1% 457 $10K
95816 <1% 221 $9K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent <1% 58 $9K
42830 <1% 64 $9K
90680 <1% 227 $9K
0002A <1% 290 $9K
99221 <1% 114 $8K
00920 <1% 65 $8K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 550 $8K
93888 <1% 381 $8K
92587 <1% 460 $8K
D0220 Intraoral - periapical first radiographic image <1% 379 $8K
51728 <1% 113 $7K
90707 <1% 93 $6K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 79 $6K
96111 <1% 51 $6K
94621 <1% 91 $6K
92552 <1% 347 $5K
99381 <1% 56 $5K
49452 <1% 48 $5K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 70 $5K
D0330 Panoramic radiographic image <1% 58 $5K
76775 <1% 180 $5K
90696 <1% 125 $4K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 56 $4K
74712 <1% 39 $4K
90656 <1% 408 $4K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 127 $4K
72141 <1% 53 $4K
70544 <1% 103 $4K
73560 <1% 581 $4K
96158 <1% 164 $4K
70360 <1% 552 $3K
90744 <1% 173 $3K
73521 <1% 424 $3K
99217 <1% 47 $3K
54161 <1% 24 $3K
73070 <1% 535 $3K
99219 <1% 26 $3K
99241 <1% 96 $3K
73564 <1% 377 $3K
76937 <1% 278 $3K
93304 <1% 100 $3K
73562 <1% 354 $3K
D0240 <1% 94 $3K
0124A <1% 71 $3K
93227 <1% 184 $3K
51797 <1% 111 $3K
0154A <1% 70 $2K
51784 <1% 121 $2K
0052A <1% 79 $2K
72156 <1% 12 $2K
74181 <1% 28 $2K
72157 <1% 12 $2K
0051A <1% 89 $2K
96170 <1% 52 $2K
88341 <1% 69 $2K
D0230 Intraoral - periapical each additional radiographic image <1% 119 $2K
90620 <1% 14 $2K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 13 $2K
D2391 Resin-based composite - one surface, posterior, primary or permanent <1% 17 $2K
90480 <1% 78 $2K
90715 <1% 113 $2K
0081A <1% 42 $2K
99252 <1% 26 $2K
72146 <1% 25 $2K
72158 <1% 14 $2K
77080 <1% 185 $2K
73552 <1% 249 $2K
93321 <1% 251 $2K
78708 <1% 32 $2K
76882 <1% 81 $2K
99383 <1% 14 $2K
76870 <1% 72 $2K
99354 <1% 14 $2K
99177 <1% 649 $2K
88312 <1% 73 $1K
74240 <1% 52 $1K
00635 <1% 14 $1K
76885 <1% 63 $1K
90836 <1% 14 $1K
96132 <1% 12 $1K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 19 $1K
99418 Prolong nursin fac eval 15m <1% 31 $1K
94664 <1% 71 $1K
76390 <1% 18 $967.70
36415 Collection of venous blood by venipuncture <1% 459 $913.31
0074A <1% 28 $900.62
94729 <1% 87 $766.33
90474 <1% 80 $737.39
99051 <1% 10,304 $705.58
85097 <1% 18 $693.20
99358 Prolong nursin fac eval 15m <1% 129 $678.56
92002 <1% 14 $676.36
96160 <1% 1,728 $660.81
62322 <1% 12 $659.16
82272 <1% 271 $624.60
88313 <1% 85 $621.36
92133 <1% 27 $586.51
90697 <1% 133 $518.91
93886 <1% 12 $504.37
92202 <1% 36 $403.65
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 39 $378.54
73030 <1% 41 $338.73
90681 <1% 16 $312.00
11900 <1% 12 $291.36
94774 <1% 14 $268.50
99457 <1% 62 $218.50
90785 <1% 18 $196.02
73000 <1% 27 $182.78
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 15 $167.65
90619 <1% 98 $157.50
93356 <1% 14 $140.57
88311 <1% 19 $137.21
96161 <1% 62 $130.08
73110 <1% 14 $105.52
99374 <1% 147 $88.80
73060 <1% 13 $82.70
80053 Comprehensive metabolic panel <1% 12 $35.17
99000 <1% 54 $29.87
36416 <1% 24 $0.04
D1354 0% 87 $0.00
99375 0% 262 $0.00
2015F 0% 371 $0.00
96150 0% 41 $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 officialNELSON, PHILLICIA (REIMBURSEMENT OFFICER)
Same official

Other billing entities under NELSON, PHILLICIA

Full network →
ProviderLocationPaid
Children's HospitalWashington, DC$242.96M
Hospital for Sick ChildrenWashington, DC$4.66M
Children's HospitalWashington, DC$2.75M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.