Pediatric Medical Group of Santa Maria INC

Pediatric Medical Group of Santa Maria INC was paid $27.63M by Medicaid between Jan 2018 and Nov 2024, across 82 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 15% of everything it billed.

33Billing provider infoPEDIATRIC MEDICAL GROUP OF SANTA MARIA INC
SANTA MARIA, CA 93454

33aNPI1811091952assigned 09/11/2006

33bProvider typePediatrics Physician

28Total paid$27.63M

24GClaims963,462

24DCodes billed82

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Pediatrics Physician providers in California

Rank by total paid#8 of 1,490

Median peer was paid$15K

This provider vs. median1,843×

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	154,297	$2.66M
2019	160,086	$4.60M
2020	138,653	$5.01M
2021	151,427	$5.87M
2022	145,690	$5.44M
2023	142,435	$2.75M
2024incomplete	70,874	$1.29M

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	15%	105,392	95,210	$4.07M
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	11%	30,945	30,786	$2.94M
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	10%	31,499	30,181	$2.82M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	8.2%	85,126	79,574	$2.27M
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	8.0%	20,028	19,983	$2.20M
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	7.1%	24,727	22,452	$1.96M
96110	Developmental screening, with scoring and documentation, per standardized instrument	6.7%	14,857	12,419	$1.85M
99051		6.3%	23,667	22,778	$1.75M
G9920	Screening performed and negative	4.1%	43,409	42,956	$1.12M
92551		3.2%	64,187	63,777	$874K
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	2.4%	15,598	15,179	$674K
D1206	Topical application of fluoride varnish	1.9%	23,241	22,640	$512K

70 more codes

87428		1.8%	6,905	$508K
99381		1.4%	3,935	$379K
99402		<1%	3,521	$263K
99173		<1%	61,363	$249K
99188		<1%	10,255	$225K
85018		<1%	81,861	$206K
90686		<1%	21,001	$196K
90670		<1%	17,151	$176K
80061	Lipid panel	<1%	11,663	$160K
90698		<1%	16,065	$153K
90680		<1%	14,956	$142K
90716		<1%	10,720	$113K
83655		<1%	8,391	$109K
90651		<1%	8,729	$101K
90707		<1%	10,300	$101K
90744		<1%	10,886	$99K
90633		<1%	10,151	$95K
96127		<1%	16,104	$95K
90685		<1%	9,966	$92K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	7,051	$87K
82962		<1%	31,505	$87K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	11,564	$86K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	6,415	$79K
G8510	Screening for depression is documented as negative, a follow-up plan is not required	<1%	7,762	$77K
87430		<1%	5,774	$70K
94664		<1%	5,517	$64K
90700		<1%	6,860	$63K
90734		<1%	5,251	$53K
90671		<1%	3,545	$46K
90621		<1%	3,639	$43K
90715		<1%	4,096	$38K
99401		<1%	3,350	$36K
90648		<1%	3,885	$35K
90619		<1%	2,510	$28K
90660		<1%	2,727	$26K
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	8,625	$23K
90696		<1%	2,236	$23K
90713		<1%	2,405	$22K
99203	Doctor's office visit, new patient (routine)	<1%	294	$18K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	1,030	$16K
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	970	$15K
99243		<1%	169	$13K
99204	Doctor's office visit, new patient (more involved)	<1%	151	$11K
90461		<1%	4,372	$8K
G9919	Screening performed and positive and provision of recommendations	<1%	298	$8K
0071A		<1%	186	$7K
0072A		<1%	119	$5K
87807		<1%	423	$4K
99383		<1%	44	$3K
90658		<1%	359	$3K
G8431	Screening for depression is documented as being positive and a follow-up plan is documented	<1%	71	$2K
90674		<1%	236	$2K
90657		<1%	233	$2K
99382		<1%	32	$2K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	29	$2K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	313	$1K
99384		<1%	12	$1K
69210		<1%	2,082	$1K
90381		<1%	70	$1K
87086	Culture, bacterial; quantitative colony count, urine	<1%	136	$1K
90380		<1%	44	$915.35
81000		<1%	3,265	$846.89
86580		<1%	91	$683.68
0001A		<1%	14	$560.00
81002		<1%	5,218	$349.62
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	594	$264.43
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	18	$97.22
99177		0%	170	$0.00
91300		0%	38	$0.00
36416		0%	1,065	$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 officialROSTERMUNDT, SHANE (PHYSICIAN MANAGER)