Germain, Sephora

Germain, Sephora was paid $159K by Medicaid between Dec 2018 and Jan 2023, across 12 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 47% of everything it billed.

33Billing provider infoGERMAIN, SEPHORA
WEST NYACK, NY 10994

33aNPI1831538149assigned 06/19/2013

33bProvider typePediatrics Physician

28Total paid$159K

24GClaims1,965

24DCodes billed12

24AFirst – last monthDec 2018 – Jan 2023

Compared with peers

Next to other Pediatrics Physician providers in New York

Rank by total paid#619 of 1,983

Median peer was paid$17K

This provider vs. median9.3×

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	13	$235.70
2019	97	$2K
2020	163	$10K
2021	669	$62K
2022	943	$76K
2023	80	$9K

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	47%	690	662	$74K
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	23%	257	242	$37K
87636	Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B	19%	215	213	$30K
90460	Immunization administration through 18 years of age via any route, first or only component	7.3%	523	512	$12K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	1.2%	29	29	$2K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	13	13	$2K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	<1%	12	12	$1K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2	<1%	30	30	$625.00
92551		<1%	12	12	$145.85
96127		<1%	13	13	$81.32
90686		<1%	158	158	$36.74
96160		0%	13	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.