Pediatric Medical Group Of Santa Maria Inc — Billing Profile & Reimbursement Data
NPI 1811091952 · Santa Maria, CA · Pediatrics Physician
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Pediatric Medical Group Of Santa Maria Inc is a pediatrics physician provider located in Santa Maria, California. This profile covers 0 Medicare and 82 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Pediatric Medical Group Of Santa Maria Inc |
| Address | 1430 E Main St |
| City | Santa Maria |
| State | CA |
| ZIP | 93454 |
| Taxonomy | Pediatrics Physician |
| NPI Enumerated | September 11, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $27.7M |
| Medicare | $0 |
Medicaid: Total Revenue Breakdown by CPT/HCPCS Code
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Medicaid: Complete Services Breakdown
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
82 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 105,390 | $40 | $4.1M |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 30,950 | $100 | $2.9M |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 31,500 | $90 | $2.8M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 85,130 | $30 | $2.3M |
| 99394 | The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17. | 20,030 | $110 | $2.2M |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 24,730 | $80 | $2M |
| 96110 | The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate… | 14,860 | $130 | $1.9M |
| 99051 | The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday. | 23,670 | $70 | $1.8M |
| G9920 | Screening performed and negative | 43,410 | $30 | $1.1M |
| 92551 | The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems. | 64,190 | $10 | $898.6K |
Showing 1–10 of 82
Medicaid: Competitive Analysis & Benchmarks
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
82 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 53 | 13,300 | 640 | $40 | $169.6K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 327 | 14,520 | 760 | $10 | $122.8K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 3,124 | 5,870 | 180 | $70 | $73K |
| 99202 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider… | 1,738 | 2,180 | 180 | $70 | $67.9K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 2,275 | 5,590 | 180 | $50 | $62.4K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 113 | 1,610 | 640 | $1 | $53.5K |
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 14 | 270 | 220 | $40 | $50.6K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 990 | 2,380 | 350 | $20 | $50.3K |
| 99243 | The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at… | 284 | 630 | 130 | $60 | $47K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 2,090 | 5,600 | 440 | $10 | $44.4K |
Showing 1–10 of 82
Nearby Providers
Other providers in the same ZIP code as Pediatric Medical Group Of Santa Maria Inc, ranked by combined Medicare and Medicaid revenue.
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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