Sylacauga Pediatric Clinic, LLC

Sylacauga Pediatric Clinic, LLC was paid $7.36M by Medicaid between Jan 2018 and Nov 2024, across 43 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 95% of everything it billed.

33Billing provider infoSYLACAUGA PEDIATRIC CLINIC, LLC
SYLACAUGA, AL 35150

33aNPI1912948373assigned 06/09/2006

33bProvider typeRural Health Clinic/Center

28Total paid$7.36M

24GClaims222,774

24DCodes billed43

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Rural Health Clinic/Center providers in Alabama

Rank by total paid#5 of 80

Median peer was paid$818K

This provider vs. median9.0×

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	29,962	$968K
2019	34,173	$1.01M
2020	30,037	$933K
2021	36,399	$1.26M
2022	36,021	$1.19M
2023	35,303	$1.18M
2024incomplete	20,879	$818K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	95%	98,630	79,159	$6.97M
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	2.2%	2,719	2,173	$162K
90670		<1%	3,857	3,387	$26K
90680		<1%	3,232	2,797	$22K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	5,819	5,358	$17K
90686		<1%	2,191	2,057	$16K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	4,940	4,414	$15K
90698		<1%	2,212	2,001	$15K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	<1%	6,145	5,519	$14K
90633		<1%	2,132	1,833	$14K
90723		<1%	1,384	1,236	$10K
90651		<1%	1,295	1,170	$9K

31 more codes

99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	4,519	$9K
90648		<1%	1,100	$8K
90734		<1%	1,002	$7K
90697		<1%	914	$5K
90620		<1%	642	$4K
90716		<1%	604	$4K
90707		<1%	569	$3K
90677		<1%	413	$3K
90688		<1%	406	$3K
99213	Doctor's office visit, returning patient (routine)	<1%	41,640	$3K
90710		<1%	354	$2K
99214	Doctor's office visit, returning patient (more involved)	<1%	23,816	$2K
90696		<1%	320	$2K
92551		<1%	3,897	$2K
99173		<1%	3,889	$2K
90647		<1%	245	$2K
90715		<1%	264	$2K
90649		<1%	264	$2K
90671		<1%	250	$2K
90619		<1%	197	$1K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	1,296	$1K
90687		<1%	212	$1K
99381		<1%	792	$957.72
90744		<1%	114	$704.00
90685		<1%	76	$488.00
90380		<1%	46	$352.00
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	0%	224	$0.00
90661		0%	25	$0.00
90460	Immunization administration through 18 years of age via any route, first or only component	0%	97	$0.00
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	0%	18	$0.00
90461		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 officialCHADALAWADA, REKHA (PRESIDENT)