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VALLEY CHILDREN'S MEDICAL GROUP

Pediatrics·MODESTO, CA·NPI: 1437555265Share

Compared to Pediatrics Peers

Total spending distribution among 14 providers in this specialty

P25MedianP75P90

This provider's total spending of $64.9M is at the 25th percentile among 14 Pediatrics providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$64.9M

$64,872,101

Total Claims

1.2M

Beneficiaries

1.0M

1.1 claims/patient

Avg Cost/Claim

$56

Monthly Spending Trend

Yearly Spending

2018
$7.7M
+3%
2019
$8.0M
-6%
2020
$7.5M
+24%
2021
$9.3M
-4%
2022
$8.9M
+27%
2023
$11.3M
+7%
2024
$12.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 16% of total spending.

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$10.6M

148K claims · 16.4%

Your Cost: $71.57/claim|Median: $53.41
1.3× median
99215Top 25%

Office/outpatient visit, high complexity

$10.1M

83K claims · 15.5%

Your Cost: $121.53/claim|Median: $74.09
1.6× median
99233Top 25%

Subsequent hospital care, per day, high complexity

$5.3M

88K claims · 8.1%

Your Cost: $59.59/claim|Median: $35.30
1.7× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$4.8M

57K claims · 7.4%

Your Cost: $84.35/claim|Median: $121.58
0.7× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$3.5M

81K claims · 5.3%

Your Cost: $42.86/claim|Median: $37.81
1.1× median
99243Normal range

Office or other outpatient consultation, low complexity

$2.4M

42K claims · 3.7%

Your Cost: $55.96/claim|Median: $82.43
0.7× median
93304Normal range

$1.5M

28K claims · 2.4%

Your Cost: $54.25/claim|Median: $54.29
1.0× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$1.3M

26K claims · 2.0%

Your Cost: $51.02/claim|Median: $43.85
1.2× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$1.2M

17K claims · 1.9%

Your Cost: $71.60/claim|Median: $106.79
0.7× median
Z0102Normal range

$1.1M

5,744 claims · 1.7%

Your Cost: $193.60/claim|Median: $193.72
1.0× median
99480Top 25%

Subsequent intensive care, very low birth weight infant

$1.1M

8,293 claims · 1.6%

Your Cost: $128.38/claim|Median: $98.15
1.3× median
99284Normal range

Emergency dept visit, high complexity

$1.1M

44K claims · 1.6%

Your Cost: $24.18/claim|Median: $69.51
0.3× median
99283Normal range

Emergency dept visit, moderate complexity

$1.0M

83K claims · 1.6%

Your Cost: $12.68/claim|Median: $42.48
0.3× median
93325Normal range

$1.0M

51K claims · 1.6%

Your Cost: $20.30/claim|Median: $14.61
1.4× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$1.0M

7,304 claims · 1.6%

Your Cost: $141.23/claim|Median: $54.68
2.6× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$981K

17K claims · 1.5%

Your Cost: $57.76/claim|Median: $84.03
0.7× median
99223Normal range

Initial hospital care, per day, high complexity

$861K

12K claims · 1.3%

Your Cost: $69.74/claim|Median: $67.32
1.0× median
99245Normal range

Office consultation, high complexity

$860K

8,693 claims · 1.3%

Your Cost: $98.95/claim|Median: $143.30
0.7× median
99469Normal range

Subsequent intensive care, very low birth weight infant

$851K

3,871 claims · 1.3%

Your Cost: $219.94/claim|Median: $293.45
0.7× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$791K

19K claims · 1.2%

Your Cost: $42.43/claim|Median: $57.85
0.7× median
93303Normal range

Echocardiography, transthoracic, limited

$777K

9,774 claims · 1.2%

Your Cost: $79.51/claim|Median: $112.83
0.7× median
88305Top 25%

Surgical pathology, gross and microscopic examination

$769K

9,439 claims · 1.2%

Your Cost: $81.44/claim|Median: $35.80
2.3× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$759K

16K claims · 1.2%

Your Cost: $47.82/claim|Median: $23.99
2.0× median
99285Normal range

Emergency dept visit, high/urgent complexity

$719K

9,002 claims · 1.1%

Your Cost: $79.86/claim|Median: $85.65
0.9× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$671K

29K claims · 1.0%

Your Cost: $22.91/claim|Median: $58.55
0.4× median
Z4305Normal range

$566K

5,706 claims · 0.9%

Your Cost: $99.13/claim|Median: $99.36
1.0× median
Z0104Normal range

$497K

3,507 claims · 0.8%

Your Cost: $141.61/claim|Median: $141.22
1.0× median
93321Normal range

$470K

23K claims · 0.7%

Your Cost: $20.11/claim|Median: $9.69
2.1× median
42820Normal range

Tonsillectomy and adenoidectomy, under age 12

$470K

3,537 claims · 0.7%

Your Cost: $133.02/claim|Median: $331.68
0.4× median
99222Normal range

Initial hospital care, per day, moderate complexity

$439K

6,473 claims · 0.7%

Your Cost: $67.77/claim|Median: $51.25
1.3× median
93000Top 1%

Electrocardiogram, complete, with interpretation and report

$421K

12K claims · 0.6%

Your Cost: $35.89/claim|Median: $9.70
3.7× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$385K

12K claims · 0.6%

Your Cost: $32.09/claim|Median: $37.22
0.9× median
93010Top 25%

Electrocardiogram, interpretation and report only

$374K

45K claims · 0.6%

Your Cost: $8.32/claim|Median: $5.60
1.5× median
99291Top 25%

Critical care, first 30-74 minutes

$339K

2,328 claims · 0.5%

Your Cost: $145.60/claim|Median: $101.24
1.4× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$321K

3,465 claims · 0.5%

Your Cost: $92.77/claim|Median: $233.73
0.4× median
99472Normal range

Subsequent pediatric critical care, per day, age 2-5

$279K

1,279 claims · 0.4%

Your Cost: $218.52/claim|Median: $307.98
0.7× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$270K

3,028 claims · 0.4%

Your Cost: $89.11/claim|Median: $111.09
0.8× median
99479Top 25%

Subsequent intensive care, 2,501-5,000 grams

$267K

1,967 claims · 0.4%

Your Cost: $135.64/claim|Median: $103.70
1.3× median
93320Normal range

$258K

7,026 claims · 0.4%

Your Cost: $36.79/claim|Median: $28.68
1.3× median
Z4306Normal range

$252K

5,090 claims · 0.4%

Your Cost: $49.43/claim|Median: $49.73
1.0× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$246K

4,476 claims · 0.4%

Your Cost: $54.89/claim|Median: $62.48
0.9× median
69436Normal range

Tympanostomy, general anesthesia

$238K

2,947 claims · 0.4%

Your Cost: $80.70/claim|Median: $205.50
0.4× median
25600Normal range

$236K

2,641 claims · 0.4%

Your Cost: $89.55/claim|Median: $193.19
0.5× median
72082Normal range

$222K

6,130 claims · 0.3%

Your Cost: $36.30/claim|Median: $31.02
1.2× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$176K

6,769 claims · 0.3%

Your Cost: $26.06/claim|Median: $38.23
0.7× median
43239Normal range

Upper GI endoscopy with biopsy

$161K

1,108 claims · 0.2%

Your Cost: $145.05/claim|Median: $151.68
1.0× median
95819Normal range

Electroencephalogram with sleep recording

$159K

2,908 claims · 0.2%

Your Cost: $54.81/claim|Median: $62.75
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$157K

6,570 claims · 0.2%

Your Cost: $23.97/claim|Median: $25.06
1.0× median
76819Normal range

Fetal biophysical profile with non-stress test

$151K

4,470 claims · 0.2%

Your Cost: $33.85/claim|Median: $49.45
0.7× median
88304Normal range

$146K

9,314 claims · 0.2%

Your Cost: $15.63/claim|Median: $12.88
1.2× median

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Los Angeles County Department of Mental Health

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$6.78B

County of Santa Clara

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$1.73B

County of Riverside

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$1.40B

City & County of San Francisco

Community/Behavioral Health

$1.34B

Los Angeles County Department of Public Health

Public Health or Welfare

$1.13B

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