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PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.

Pediatrics, Neonatal-Perinatal Medicine·HOUSTON, TX·NPI: 1649377359Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$85.3M

$85,334,059

Total Claims

874K

Beneficiaries

647K

1.4 claims/patient

Avg Cost/Claim

$98

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+6%
2019
$1.4M
+237%
2020
$4.8M
+276%
2021
$18.0M
+22%
2022
$22.0M
-3%
2023
$21.2M
-22%
2024
$16.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99469 (Subsequent intensive care, very low birth weight infant)) accounts for 28% of total spending.

99469Top 25%

Subsequent intensive care, very low birth weight infant

$23.9M

65K claims · 28.0%

Your Cost: $369.01/claim|Median: $293.45
1.3× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$12.0M

153K claims · 14.0%

Your Cost: $77.97/claim|Median: $62.48
1.2× median
99479Top 25%

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

$11.5M

92K claims · 13.5%

Your Cost: $125.41/claim|Median: $103.70
1.2× median
99480Top 25%

Subsequent intensive care, very low birth weight infant

$10.9M

93K claims · 12.7%

Your Cost: $116.89/claim|Median: $98.15
1.2× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$10.2M

170K claims · 11.9%

Your Cost: $60.00/claim|Median: $37.22
1.6× median
99472Top 25%

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

$4.7M

13K claims · 5.5%

Your Cost: $369.47/claim|Median: $307.98
1.2× median
99462Top 25%

$3.0M

80K claims · 3.6%

Your Cost: $38.13/claim|Median: $27.49
1.4× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$1.4M

35K claims · 1.6%

Your Cost: $39.33/claim|Median: $23.99
1.6× median
99464Top 25%

$1.0M

13K claims · 1.2%

Your Cost: $82.77/claim|Median: $59.94
1.4× median
54150Normal range

$993K

13K claims · 1.2%

Your Cost: $74.05/claim|Median: $84.60
0.9× median
99214Normal range

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

$857K

17K claims · 1.0%

Your Cost: $49.44/claim|Median: $53.41
0.9× median
99468Top 25%

$638K

755 claims · 0.7%

Your Cost: $845.52/claim|Median: $679.18
1.2× median
99283Normal range

Emergency dept visit, moderate complexity

$574K

14K claims · 0.7%

Your Cost: $39.66/claim|Median: $42.48
0.9× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$566K

7,755 claims · 0.7%

Your Cost: $72.93/claim|Median: $69.35
1.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$499K

6,351 claims · 0.6%

Your Cost: $78.50/claim|Median: $75.18
1.0× median
99213Normal range

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

$493K

14K claims · 0.6%

Your Cost: $34.89/claim|Median: $37.81
0.9× median
99463Top 25%

$316K

2,965 claims · 0.4%

Your Cost: $106.67/claim|Median: $78.46
1.4× median
99239Top 25%

Hospital discharge day management, more than 30 minutes

$239K

2,966 claims · 0.3%

Your Cost: $80.75/claim|Median: $43.85
1.8× median
99284Normal range

Emergency dept visit, high complexity

$229K

3,125 claims · 0.3%

Your Cost: $73.39/claim|Median: $69.51
1.1× median
99282Normal range

Emergency dept visit, low complexity

$164K

5,798 claims · 0.2%

Your Cost: $28.28/claim|Median: $37.72
0.7× median
92650Top 10%

$143K

1,873 claims · 0.2%

Your Cost: $76.56/claim|Median: $31.90
2.4× median
90472Normal range

Immunization administration, each additional vaccine

$139K

14K claims · 0.2%

Your Cost: $9.75/claim|Median: $11.79
0.8× median
99222Top 10%

Initial hospital care, per day, moderate complexity

$138K

1,312 claims · 0.2%

Your Cost: $105.33/claim|Median: $51.25
2.1× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$121K

11K claims · 0.1%

Your Cost: $10.62/claim|Median: $9.80
1.1× median
92586Normal range

$101K

1,661 claims · 0.1%

Your Cost: $60.84/claim|Median: $51.18
1.2× median
99215Normal range

Office/outpatient visit, high complexity

$99K

1,374 claims · 0.1%

Your Cost: $72.12/claim|Median: $74.09
1.0× median
99393Normal range

Preventive medicine, established patient, age 5-11

$90K

1,132 claims · 0.1%

Your Cost: $79.71/claim|Median: $74.82
1.1× median
99231Top 25%

Subsequent hospital care, per day, low complexity

$82K

2,763 claims · 0.1%

Your Cost: $29.75/claim|Median: $16.77
1.8× median
96110Normal range

Developmental screening, per standardized instrument

$58K

7,222 claims · 0.1%

Your Cost: $8.04/claim|Median: $9.10
0.9× median
99223Top 25%

Initial hospital care, per day, high complexity

$53K

418 claims · 0.1%

Your Cost: $125.94/claim|Median: $67.32
1.9× median
96112Normal range

Developmental test administration

$48K

615 claims · 0.1%

Your Cost: $77.85/claim|Median: $102.95
0.8× median
87428Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$22K

722 claims · 0.0%

Your Cost: $30.40/claim|Median: $39.63
0.8× median
90474Normal range

$21K

2,467 claims · 0.0%

Your Cost: $8.50/claim|Median: $8.42
1.0× median
99254Normal range

$15K

138 claims · 0.0%

Your Cost: $110.06/claim|Median: $81.43
1.4× median
99477Top 10%

$14K

37 claims · 0.0%

Your Cost: $385.15/claim|Median: $276.41
1.4× median
76815Normal range

Ultrasound, pregnant uterus, limited

$13K

699 claims · 0.0%

Your Cost: $18.47/claim|Median: $36.79
0.5× median
92587Normal range

$9K

606 claims · 0.0%

Your Cost: $15.21/claim|Median: $19.24
0.8× median
99233Top 25%

Subsequent hospital care, per day, high complexity

$9K

144 claims · 0.0%

Your Cost: $63.16/claim|Median: $35.30
1.8× median
99221Top 25%

Initial hospital care, straightforward/low

$6K

93 claims · 0.0%

Your Cost: $66.88/claim|Median: $39.96
1.7× median
59025Normal range

Fetal non-stress test

$6K

288 claims · 0.0%

Your Cost: $19.97/claim|Median: $26.45
0.8× median
87804Normal range

Influenza virus detection, rapid test

$5K

439 claims · 0.0%

Your Cost: $11.93/claim|Median: $12.59
0.9× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$5K

398 claims · 0.0%

Your Cost: $12.08/claim|Median: $11.48
1.1× median
59514Normal range

Cesarean delivery only

$5K

13 claims · 0.0%

Your Cost: $364.15/claim|Median: $452.80
0.8× median
99203Normal range

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

$4K

102 claims · 0.0%

Your Cost: $36.60/claim|Median: $57.85
0.6× median
99281Normal range

Emergency dept visit, minimal complexity

$3K

191 claims · 0.0%

Your Cost: $17.55/claim|Median: $52.03
0.3× median
99212Normal range

Office/outpatient visit, low complexity

$3K

138 claims · 0.0%

Your Cost: $23.18/claim|Median: $25.06
0.9× median
87811Top 10%

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$3K

68 claims · 0.0%

Your Cost: $41.07/claim|Median: $30.53
1.3× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$2K

26 claims · 0.0%

Your Cost: $76.76/claim|Median: $111.09
0.7× median
0071ATop 25%

$2K

45 claims · 0.0%

Your Cost: $44.03/claim|Median: $38.71
1.1× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$2K

160 claims · 0.0%

Your Cost: $10.99/claim|Median: $9.56
1.1× median

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