In one large, national health plan, between 2011 and 2016 the number of annual pediatric direct-to-consumer (DTC) telemedicine visits rose from 38 visits during 2011 to 24,409 during 2016. In 2016, the rate of pediatric DCT telemedicine was about 800 visits per 100,000 member years, and 7 DTC telemedicine visits for every 1,000 acute PCP visits. About 6% of DTC telemedicine visits were for children age 2 or under. During 2015 to 2016, the likelihood of pediatric DTC telemedicine use was 45% higher for children in non-metropolitan communities, about 50% higher among children in . . .