Surprise Pediatrics
Surprise Pediatrics was paid $1.79M by Medicaid between Jan 2018 and Feb 2022, across 37 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 43% of everything it billed.
33Billing provider infoSURPRISE PEDIATRICS
SURPRISE, AZ 85374
SURPRISE, AZ 85374
33aNPI1801893425assigned 06/29/2005
33bProvider typeLegal Medicine
28Total paid$1.79M
24GClaims50,074
24DCodes billed37
24AFirst – last monthJan 2018 – Feb 2022
Compared with peers
Next to other Legal Medicine providers in Arizona
Rank by total paid#1 of 7
Median peer was paid$26K
This provider vs. median70×
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 | 14,523 | $489K | |
| 2019 | 14,475 | $481K | |
| 2020 | 10,864 | $376K | |
| 2021 | 9,284 | $400K | |
| 2022 | 928 | $48K |
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 | 43% | 16,587 | 15,183 | $777K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 16% | 6,323 | 6,179 | $280K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 11% | 2,792 | 2,742 | $203K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 11% | 2,741 | 2,631 | $194K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.5% | 2,163 | 2,123 | $152K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.6% | 844 | 796 | $65K |
| 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 | 2.4% | 631 | 597 | $43K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 1,945 | 1,851 | $25K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,049 | 985 | $15K |
| 99381 | <1% | 132 | 132 | $12K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 349 | 335 | $9K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 115 | 113 | $8K |
25 more codes
| 99383 | <1% | 50 | $4K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 928 | $3K |
| 96127 | <1% | 291 | $933.01 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 27 | $687.15 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 46 | $444.94 |
| 99173 | <1% | 1,139 | $427.02 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 13 | $308.41 |
| 90686 | <1% | 1,260 | $86.85 | |
| 81002 | <1% | 13 | $31.46 | |
| 99000 | <1% | 23 | $30.00 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 25 | $0.02 |
| 90680 | 0% | 908 | $0.00 | |
| 90716 | 0% | 416 | $0.00 | |
| 90651 | 0% | 279 | $0.00 | |
| 90698 | 0% | 445 | $0.00 | |
| 90744 | 0% | 600 | $0.00 | |
| 90648 | 0% | 1,332 | $0.00 | |
| 90700 | 0% | 1,918 | $0.00 | |
| 90713 | 0% | 1,473 | $0.00 | |
| 90633 | 0% | 545 | $0.00 | |
| 90670 | 0% | 1,936 | $0.00 | |
| 90707 | 0% | 381 | $0.00 | |
| 90734 | 0% | 111 | $0.00 | |
| 90685 | 0% | 210 | $0.00 | |
| 90715 | 0% | 34 | $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 officialPHAM, NICHOLAS (CEO)