NP / PA
Pediatric Advanced Care of West Haven LLC
Pediatric Advanced Care of West Haven LLC was paid $2.40M by Medicaid between Jan 2018 and Dec 2024, across 53 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 35% of everything it billed.
33Billing provider infoPEDIATRIC ADVANCED CARE OF WEST HAVEN LLC
WEST HAVEN, CT 06516
WEST HAVEN, CT 06516
33aNPI1942669916assigned 02/18/2016
33bProvider typePediatric Nurse Practitioner
28Total paid$2.40M
24GClaims84,888
24DCodes billed53
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Nurse Practitioner providers in Connecticut
Rank by total paid#3 of 31
Median peer was paid$8K
This provider vs. median316×
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 | 11,811 | $368K | |
| 2019 | 13,241 | $346K | |
| 2020 | 12,352 | $308K | |
| 2021 | 10,269 | $319K | |
| 2022 | 15,054 | $386K | |
| 2023 | 12,233 | $329K | |
| 2024incomplete | 9,928 | $343K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 35% | 10,069 | 8,059 | $834K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 11% | 2,644 | 2,318 | $254K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 10% | 4,588 | 3,573 | $240K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 8.8% | 6,480 | 5,654 | $210K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.6% | 2,397 | 1,965 | $205K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.7% | 2,032 | 1,757 | $161K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.8% | 4,764 | 4,278 | $68K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 2.7% | 2,167 | 1,805 | $65K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.7% | 700 | 635 | $65K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.5% | 4,894 | 2,919 | $59K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.1% | 1,387 | 1,342 | $50K |
| 99174 | 1.6% | 2,502 | 2,208 | $38K |
41 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 2,943 | $26K |
| 92551 | <1% | 4,399 | $21K | |
| 36416 | <1% | 6,887 | $18K | |
| 96127 | <1% | 943 | $12K | |
| 99173 | <1% | 2,067 | $12K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 1,117 | $11K |
| 99051 | <1% | 1,604 | $9K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 68 | $8K |
| 83655 | <1% | 861 | $8K | |
| 94760 | <1% | 5,398 | $7K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 269 | $6K |
| 80061 | Lipid panel | <1% | 468 | $5K |
| 87807 | <1% | 461 | $4K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 16 | $1K |
| 99381 | <1% | 12 | $1K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 38 | $1K |
| 96161 | <1% | 44 | $567.00 | |
| 85018 | <1% | 6,712 | $286.21 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 13 | $100.10 |
| 94664 | <1% | 12 | $99.36 | |
| 94761 | <1% | 14 | $40.32 | |
| 81002 | <1% | 15 | $2.20 | |
| J7610 | Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg | <1% | 13 | $1.30 |
| A4616 | Tubing (oxygen), per foot | 0% | 13 | $0.00 |
| 90698 | 0% | 467 | $0.00 | |
| 90646 | 0% | 14 | $0.00 | |
| 90686 | 0% | 2,438 | $0.00 | |
| 90744 | 0% | 37 | $0.00 | |
| 90680 | 0% | 614 | $0.00 | |
| A7015 | Aerosol mask, used with dme nebulizer | 0% | 13 | $0.00 |
| 90723 | 0% | 81 | $0.00 | |
| 90696 | 0% | 43 | $0.00 | |
| 90651 | 0% | 29 | $0.00 | |
| 90716 | 0% | 28 | $0.00 | |
| 90648 | 0% | 118 | $0.00 | |
| 90670 | 0% | 1,277 | $0.00 | |
| 90685 | 0% | 114 | $0.00 | |
| 90633 | 0% | 433 | $0.00 | |
| 90707 | 0% | 30 | $0.00 | |
| 90734 | 0% | 98 | $0.00 | |
| 90710 | 0% | 43 | $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 officialMARCUCIO, ELIZABETH (OWNER)