Clinic
Pediatric Associates of MT. Carmel, INC.
Pediatric Associates of MT. Carmel, INC. was paid $2.44M by Medicaid between Jan 2018 and Dec 2024, across 46 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.
33Billing provider infoPEDIATRIC ASSOCIATES OF MT. CARMEL, INC.
CINCINNATI, OH 45245
CINCINNATI, OH 45245
33aNPI1912110990assigned 05/07/2007
33bProvider typePrimary Care Clinic/Center
28Total paid$2.44M
24GClaims84,427
24DCodes billed46
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Ohio
Rank by total paid#5 of 118
Median peer was paid$67K
This provider vs. median37×
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 | 9,850 | $313K | |
| 2019 | 10,007 | $319K | |
| 2020 | 9,251 | $266K | |
| 2021 | 12,406 | $351K | |
| 2022 | 13,442 | $407K | |
| 2023 | 13,151 | $377K | |
| 2024incomplete | 16,320 | $409K |
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 | 37% | 21,372 | 20,038 | $898K |
| 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 | 30% | 11,460 | 10,775 | $721K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 13% | 11,695 | 9,527 | $307K |
| 99051 | 5.8% | 6,647 | 6,285 | $141K | |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 2.3% | 979 | 712 | $55K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.1% | 866 | 841 | $51K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.9% | 3,861 | 3,630 | $48K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.7% | 459 | 426 | $41K |
| 92552 | 1.3% | 2,735 | 2,633 | $31K | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | 1.2% | 437 | 320 | $30K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.2% | 535 | 515 | $28K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.1% | 464 | 441 | $26K |
34 more codes
| G0312 | Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes) | <1% | 872 | $24K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 676 | $13K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 209 | $7K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 39 | $4K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 55 | $3K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 67 | $3K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 55 | $3K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 142 | $2K |
| 99177 | <1% | 183 | $2K | |
| 99173 | <1% | 684 | $2K | |
| 96127 | <1% | 340 | $1K | |
| 90633 | <1% | 14 | $804.00 | |
| 99401 | <1% | 38 | $798.08 | |
| 90688 | <1% | 1,445 | $766.78 | |
| 90661 | <1% | 193 | $687.66 | |
| 90677 | <1% | 12 | $613.96 | |
| 99417 | Prolong home eval add 15m | <1% | 12 | $283.20 |
| 36416 | <1% | 77 | $278.13 | |
| 90698 | <1% | 38 | $175.78 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 13 | $112.94 |
| 90785 | <1% | 24 | $99.68 | |
| 90686 | <1% | 209 | $69.29 | |
| J8540 | Dexamethasone, oral, 0.25 mg | <1% | 12 | $31.37 |
| 97802 | <1% | 4,691 | $26.30 | |
| 90687 | <1% | 189 | $19.93 | |
| 91307 | <1% | 27 | $0.27 | |
| 90461 | 0% | 2,280 | $0.00 | |
| 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) | 0% | 3,387 | $0.00 |
| 99072 | 0% | 2,107 | $0.00 | |
| 90670 | 0% | 51 | $0.00 | |
| 90707 | 0% | 13 | $0.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 0% | 3,530 | $0.00 |
| 99000 | 0% | 1,220 | $0.00 | |
| 90716 | 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 officialCHAMBERLIN, MICHAEL (PRESIDENT)