Clinic
Blue Ridge Pediatrics LLC
Blue Ridge Pediatrics LLC was paid $5.57M by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 48% of everything it billed.
33Billing provider infoBLUE RIDGE PEDIATRICS LLC
SENECA, SC 29678
SENECA, SC 29678
33aNPI1104130376assigned 07/30/2010
33bProvider typeRural Health Clinic/Center
28Total paid$5.57M
24GClaims60,585
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in South Carolina
Rank by total paid#3 of 81
Median peer was paid$302K
This provider vs. median18×
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 | 8,595 | $701K | |
| 2019 | 8,131 | $672K | |
| 2020 | 7,415 | $580K | |
| 2021 | 9,208 | $795K | |
| 2022 | 10,142 | $992K | |
| 2023 | 9,262 | $971K | |
| 2024incomplete | 7,832 | $858K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 48% | 27,828 | 21,597 | $2.67M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 21% | 12,316 | 9,701 | $1.15M |
| 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 | 7.8% | 4,418 | 3,928 | $435K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.3% | 3,609 | 3,538 | $350K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.8% | 3,478 | 3,370 | $326K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.7% | 2,687 | 2,652 | $264K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.5% | 2,646 | 2,520 | $248K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.0% | 1,910 | 1,610 | $56K |
| G9153 | Mapcp demonstration - physician incentive pool | <1% | 693 | 692 | $45K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 164 | 162 | $8K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 169 | 166 | $4K |
| 90461 | <1% | 138 | 135 | $3K |
14 more codes
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 27 | $3K |
| 0071A | <1% | 12 | $480.00 | |
| 0001A | <1% | 12 | $400.00 | |
| 90670 | 0% | 55 | $0.00 | |
| 90633 | 0% | 34 | $0.00 | |
| 90707 | 0% | 39 | $0.00 | |
| 90672 | 0% | 55 | $0.00 | |
| 90734 | 0% | 30 | $0.00 | |
| 90686 | 0% | 175 | $0.00 | |
| 90716 | 0% | 27 | $0.00 | |
| 90723 | 0% | 24 | $0.00 | |
| 90647 | 0% | 13 | $0.00 | |
| 90680 | 0% | 12 | $0.00 | |
| 90651 | 0% | 14 | $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 officialGULLY, CAREY (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Blue Ridge Pediatrics LLC | Seneca, SC | $1.11M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.