Physician
Pinnacle Pediatrics and Internal Medicine Professional LLC
Pinnacle Pediatrics and Internal Medicine Professional LLC was paid $480K by Medicaid between Mar 2018 and Dec 2024, across 31 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
33Billing provider infoPINNACLE PEDIATRICS AND INTERNAL MEDICINE PROFESSIONAL LLC
WESTMINSTER, CO 80023
WESTMINSTER, CO 80023
33aNPI1871018085assigned 08/08/2017
33bProvider typeInternal Medicine Physician
28Total paid$480K
24GClaims12,489
24DCodes billed31
24AFirst – last monthMar 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in Colorado
Rank by total paid#39 of 193
Median peer was paid$34K
This provider vs. median14×
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 | 465 | $22K | |
| 2019 | 766 | $39K | |
| 2020 | 1,141 | $50K | |
| 2021 | 2,023 | $79K | |
| 2022 | 2,270 | $110K | |
| 2023 | 2,301 | $91K | |
| 2024incomplete | 3,523 | $89K |
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 | 35% | 2,982 | 2,399 | $170K |
| 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% | 1,376 | 1,151 | $111K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 16% | 2,413 | 1,766 | $76K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.7% | 625 | 503 | $46K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.0% | 344 | 283 | $24K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 4.5% | 2,000 | 1,532 | $22K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.1% | 132 | 113 | $10K |
| D1206 | Topical application of fluoride varnish | <1% | 318 | 270 | $5K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 138 | 97 | $3K |
| 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 | <1% | 21 | 12 | $2K |
| 90686 | <1% | 487 | 430 | $2K | |
| 92551 | <1% | 152 | 142 | $2K |
19 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 15 | $1K |
| 90670 | <1% | 111 | $1K | |
| 99173 | <1% | 274 | $913.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 16 | $815.93 |
| 0071A | <1% | 32 | $733.97 | |
| 0072A | <1% | 21 | $625.31 | |
| 90673 | <1% | 55 | $548.48 | |
| 96127 | <1% | 80 | $416.65 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 18 | $372.42 |
| 90461 | <1% | 327 | $364.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 17 | $294.84 |
| 90648 | <1% | 264 | $271.17 | |
| 90671 | <1% | 90 | $216.09 | |
| 90656 | <1% | 31 | $141.18 | |
| 90723 | <1% | 58 | $107.30 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 18 | $59.34 |
| 36415 | Collection of venous blood by venipuncture | <1% | 15 | $41.08 |
| 90680 | 0% | 46 | $0.00 | |
| 90651 | 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 officialWILSON, WALTER (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Hope and Healing Counseling, LLC | Cheyenne, WY | $217K |
| Wyoming Physical Therapy PC | Cheyenne, WY | $134K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.