Pediatric and Family Medical Center
Pediatric and Family Medical Center was paid $71.67M by Medicaid between Jan 2018 and Dec 2024, across 125 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 91% of everything it billed.
33Billing provider infoPEDIATRIC AND FAMILY MEDICAL CENTER
SHERMAN OAKS, CA 91403
SHERMAN OAKS, CA 91403
33aNPI1982075107assigned 10/14/2015
33bProvider typeCase Manager/Care Coordinator
28Total paid$71.67M
24GClaims700,042
24DCodes billed125
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Case Manager/Care Coordinator providers in California
Rank by total paid#22 of 435
Median peer was paid$2.89M
This provider vs. median25×
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 | 11,840 | $2.24M | |
| 2019 | 56,987 | $6.62M | |
| 2020 | 102,752 | $8.85M | |
| 2021 | 117,622 | $11.79M | |
| 2022 | 91,544 | $9.50M | |
| 2023 | 103,005 | $10.67M | |
| 2024incomplete | 216,292 | $22.00M |
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 | 91% | 246,140 | 209,346 | $65.37M |
| 00003 | Internal/system code - not a standard HCPCS code | 7.4% | 16,682 | 14,178 | $5.28M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 119,032 | 87,633 | $370K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 25,495 | 19,091 | $110K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 9,230 | 7,871 | $67K |
| 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 | <1% | 24,710 | 19,243 | $63K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 6,887 | 6,146 | $46K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 8,274 | 6,319 | $43K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 4,906 | 3,890 | $43K |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | <1% | 679 | 485 | $33K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 6,177 | 4,506 | $28K |
| 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% | 2,829 | 2,407 | $27K |
113 more codes
| G9012 | Other specified case management service not elsewhere classified | <1% | 308 | $24K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 4,586 | $21K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 2,057 | $16K |
| 59425 | <1% | 340 | $13K | |
| 90686 | <1% | 9,474 | $12K | |
| 92551 | <1% | 18,211 | $10K | |
| 90670 | <1% | 5,047 | $10K | |
| 90648 | <1% | 5,401 | $9K | |
| 81025 | <1% | 5,489 | $6K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 321 | $5K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,319 | $5K |
| 17110 | <1% | 475 | $5K | |
| 90723 | <1% | 3,302 | $5K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 11,428 | $4K |
| 90837 | Psychotherapy session, about an hour | <1% | 911 | $4K |
| G9920 | Screening performed and negative | <1% | 3,359 | $4K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 2,199 | $3K |
| 90651 | <1% | 1,274 | $3K | |
| 90633 | <1% | 1,613 | $3K | |
| 81002 | <1% | 13,129 | $2K | |
| 85018 | <1% | 6,516 | $2K | |
| 96127 | <1% | 6,899 | $1K | |
| 99173 | <1% | 18,466 | $1K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 273 | $1K |
| 92552 | <1% | 143 | $1K | |
| 90746 | <1% | 92 | $1K | |
| G0467 | Community health center visit, returning patient | <1% | 94 | $1K |
| J3490 | Unclassified drugs | <1% | 36 | $1K |
| D0120 | Dental checkup, returning patient | <1% | 243 | $961.00 |
| 90681 | <1% | 1,033 | $945.00 | |
| 0011A | <1% | 17 | $938.00 | |
| 92081 | <1% | 1,152 | $788.09 | |
| 90707 | <1% | 227 | $765.00 | |
| 0502F | <1% | 9,148 | $723.16 | |
| 90677 | <1% | 525 | $711.12 | |
| 11102 | <1% | 48 | $692.45 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 72 | $648.20 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 158 | $594.33 |
| 90716 | <1% | 262 | $585.00 | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 60 | $580.86 |
| 90700 | <1% | 287 | $576.00 | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 63 | $542.00 |
| 99385 | <1% | 28 | $361.22 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,380 | $325.95 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 588 | $316.00 |
| G9919 | Screening performed and positive and provision of recommendations | <1% | 198 | $290.00 |
| 90715 | <1% | 163 | $273.76 | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 63 | $237.20 |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 63 | $235.77 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 561 | $182.14 |
| 90461 | <1% | 5,423 | $174.34 | |
| D0274 | Bitewings - four radiographic images | <1% | 81 | $172.80 |
| 90734 | <1% | 470 | $171.00 | |
| D0330 | Panoramic radiographic image | <1% | 55 | $167.00 |
| 99000 | <1% | 2,935 | $153.21 | |
| 1159F | <1% | 5,721 | $144.24 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 87 | $129.28 |
| 90656 | <1% | 1,044 | $115.43 | |
| D1110 | Prophylaxis - adult | <1% | 19 | $105.00 |
| 90710 | <1% | 104 | $81.00 | |
| D1206 | Topical application of fluoride varnish | <1% | 70 | $78.00 |
| 99381 | <1% | 116 | $45.33 | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 63 | $37.15 |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 14 | $33.64 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 265 | $27.96 |
| 92015 | Determination of refractive state | <1% | 467 | $23.95 |
| 11900 | <1% | 38 | $20.16 | |
| 90619 | <1% | 45 | $18.00 | |
| 87400 | <1% | 88 | $11.58 | |
| 90696 | <1% | 70 | $9.00 | |
| 90620 | <1% | 152 | $9.00 | |
| 82962 | <1% | 91 | $8.00 | |
| Z6400 | 0% | 2,724 | $0.00 | |
| 3078F | 0% | 8,334 | $0.00 | |
| 3725F | 0% | 8,882 | $0.00 | |
| 1160F | 0% | 4,565 | $0.00 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 0% | 18 | $0.00 |
| Z6304 | 0% | 826 | $0.00 | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 0% | 34 | $0.00 |
| Z6500 | 0% | 622 | $0.00 | |
| 90661 | 0% | 331 | $0.00 | |
| Z6414 | 0% | 306 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 19 | $0.00 |
| 90678 | 0% | 15 | $0.00 | |
| Z6208 | 0% | 142 | $0.00 | |
| Z6308 | 0% | 128 | $0.00 | |
| 99401 | 0% | 12 | $0.00 | |
| 1036F | 0% | 2,236 | $0.00 | |
| Z1034 | 0% | 11,227 | $0.00 | |
| 3074F | 0% | 8,945 | $0.00 | |
| 3008F | 0% | 16,177 | $0.00 | |
| Z6204 | 0% | 885 | $0.00 | |
| 0500F | 0% | 307 | $0.00 | |
| Z6406 | 0% | 1,711 | $0.00 | |
| Z6410 | 0% | 1,032 | $0.00 | |
| Z1032 | 0% | 424 | $0.00 | |
| 0501F | 0% | 898 | $0.00 | |
| 3079F | 0% | 613 | $0.00 | |
| D1330 | 0% | 256 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 218 | $0.00 |
| 3075F | 0% | 162 | $0.00 | |
| 92250 | 0% | 40 | $0.00 | |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | 0% | 122 | $0.00 |
| 2023F | 0% | 29 | $0.00 | |
| 0503F | 0% | 42 | $0.00 | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 0% | 20 | $0.00 |
| J7611 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg | 0% | 30 | $0.00 |
| Z1038 | 0% | 54 | $0.00 | |
| Z6404 | 0% | 41 | $0.00 | |
| 92567 | 0% | 13 | $0.00 | |
| 17000 | 0% | 16 | $0.00 | |
| 90674 | 0% | 14 | $0.00 | |
| 90647 | 0% | 12 | $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 officialMCCARTHY, MONICA (SR VP, COO & INTERIM-CEO)
| Provider | Location | Paid |
|---|---|---|
| Pediatric and Family Medical Center | Los Angeles, CA | $45.33M |
| Pediatric and Family Medical Center | Los Angeles, CA | $39.58M |
| Pediatric and Family Medical Center | Los Angeles, CA | $26.37M |
| Pediatric and Family Medical Center | Lynwood, CA | $14.99M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.