Physician
Elkin Pediatric & Adult Medicine, PA
Elkin Pediatric & Adult Medicine, PA was paid $1.99M by Medicaid between Jan 2018 and Dec 2024, across 42 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 52% of everything it billed.
33Billing provider infoELKIN PEDIATRIC & ADULT MEDICINE, PA
ELKIN, NC 28621
ELKIN, NC 28621
33aNPI1083684898assigned 01/24/2006
33bProvider typeFamily Medicine Physician
28Total paid$1.99M
24GClaims143,683
24DCodes billed42
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in North Carolina
Rank by total paid#63 of 960
Median peer was paid$135K
This provider vs. median15×
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 | 7,398 | $245K | |
| 2019 | 8,821 | $288K | |
| 2020 | 5,953 | $197K | |
| 2021 | 20,164 | $316K | |
| 2022 | 35,858 | $355K | |
| 2023 | 34,639 | $316K | |
| 2024incomplete | 30,850 | $269K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 52% | 19,217 | 16,653 | $1.03M |
| 99199 | Unlisted special service, procedure or report | 18% | 92,893 | 46,764 | $367K |
| 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 | 7.1% | 1,955 | 1,694 | $140K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.7% | 5,986 | 5,247 | $73K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.2% | 821 | 735 | $64K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 3.0% | 1,785 | 1,629 | $60K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.0% | 4,486 | 2,186 | $59K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.9% | 804 | 705 | $58K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.2% | 2,565 | 2,170 | $44K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.7% | 377 | 362 | $35K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 1,442 | 1,308 | $15K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 829 | 783 | $11K |
30 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 68 | $7K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 243 | $5K |
| 87081 | <1% | 598 | $4K | |
| 92551 | <1% | 2,320 | $3K | |
| 99173 | <1% | 2,293 | $2K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 89 | $2K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 196 | $1K |
| 90474 | <1% | 65 | $1K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 113 | $969.45 |
| 90686 | <1% | 709 | $933.55 | |
| D1206 | Topical application of fluoride varnish | <1% | 83 | $724.04 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 35 | $644.46 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 13 | $324.22 |
| 90688 | <1% | 149 | $310.65 | |
| 90473 | <1% | 22 | $293.08 | |
| 90672 | <1% | 22 | $198.56 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 106 | $0.00 |
| 90648 | 0% | 194 | $0.00 | |
| 90670 | 0% | 304 | $0.00 | |
| 90687 | 0% | 71 | $0.00 | |
| 3078F | 0% | 16 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 2,292 | $0.00 |
| 90680 | 0% | 104 | $0.00 | |
| 90723 | 0% | 26 | $0.00 | |
| 90698 | 0% | 119 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 162 | $0.00 |
| 3074F | 0% | 33 | $0.00 | |
| 90656 | 0% | 53 | $0.00 | |
| 90677 | 0% | 12 | $0.00 | |
| 90744 | 0% | 13 | $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 officialHUTCHENS, DONNA (OFFICE MANAGER)