Jackson Pediatric Associates, LLC

Jackson Pediatric Associates, LLC was paid $15K by Medicaid between Jan 2018 and Oct 2024, across 8 billing codes. Its largest line is 99391, Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) — 36% of everything it billed.

33Billing provider infoJACKSON PEDIATRIC ASSOCIATES, LLC
JACKSON, WY 83001

33aNPI1912335530assigned 10/16/2013

33bProvider typePrimary Care Clinic/Center

28Total paid$15K

24GClaims708

24DCodes billed8

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Primary Care Clinic/Center providers in Wyoming

Rank by total paid#3 of 6

Median peer was paid$12K

This provider vs. median1.3×

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	288	$8K
2019	60	$3K
2020	167	$2K
2021	63	$733.12
2023	70	$835.51
2024incomplete	60	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	36%	73	63	$5K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	35%	492	462	$5K
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	16%	26	25	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	9.7%	27	26	$1K
90472	Immunization administration, each additional vaccine (list separately)	3.9%	39	37	$597.07
90686		<1%	14	13	$22.39
90688		0%	24	24	$0.00
90656		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.

From NPPES

Who's on the registration

Authorized officialRIDDELL, TRAVIS (PEDIATRICIAN)

Same official

Other billing entities under RIDDELL, TRAVIS

Full network →

Provider	Location	Paid
County of Teton	Jackson, WY	$628.58

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.