Clinic
Cumberland Pediatric Associates PC
Cumberland Pediatric Associates PC was paid $12.38M by Medicaid between Jan 2018 and Dec 2024, across 87 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 20% of everything it billed.
33Billing provider infoCUMBERLAND PEDIATRIC ASSOCIATES PC
LEBANON, TN 37087
LEBANON, TN 37087
33aNPI1104964576assigned 02/01/2007
33bProvider typeRural Health Clinic/Center
28Total paid$12.38M
24GClaims529,605
24DCodes billed87
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Tennessee
Rank by total paid#2 of 96
Median peer was paid$127K
This provider vs. median98×
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 | 57,032 | $1.29M | |
| 2019 | 96,317 | $2.04M | |
| 2020 | 70,284 | $1.56M | |
| 2021 | 75,903 | $1.70M | |
| 2022 | 80,430 | $2.05M | |
| 2023 | 80,716 | $2.03M | |
| 2024incomplete | 68,923 | $1.71M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 20% | 38,659 | 33,985 | $2.53M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 20% | 58,342 | 50,476 | $2.52M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 61,623 | 25,901 | $1.41M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.7% | 16,170 | 14,353 | $1.07M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.8% | 13,113 | 11,719 | $847K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 6.7% | 42,789 | 31,143 | $830K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.2% | 13,145 | 11,206 | $764K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.6% | 6,067 | 5,314 | $444K |
| 87428 | 1.8% | 3,921 | 3,592 | $229K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.5% | 6,362 | 5,347 | $180K |
| 92551 | 1.4% | 25,030 | 21,947 | $177K | |
| 96161 | <1% | 11,495 | 9,421 | $124K |
75 more codes
| 96127 | <1% | 33,941 | $123K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 11,988 | $112K |
| 99173 | <1% | 25,031 | $109K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 9,247 | $104K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 2,551 | $96K |
| 96160 | <1% | 8,036 | $88K | |
| D1206 | Topical application of fluoride varnish | <1% | 3,750 | $63K |
| 99177 | <1% | 9,968 | $57K | |
| D0190 | <1% | 3,750 | $37K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 524 | $37K |
| 3008F | <1% | 9,161 | $34K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,257 | $30K |
| 83655 | <1% | 2,556 | $28K | |
| 90651 | <1% | 2,875 | $26K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 506 | $23K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 568 | $20K |
| 99051 | <1% | 4,730 | $18K | |
| 99383 | <1% | 241 | $18K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 198 | $18K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 282 | $18K |
| 99381 | <1% | 259 | $16K | |
| 90670 | <1% | 8,373 | $14K | |
| 99460 | <1% | 361 | $14K | |
| 90671 | <1% | 1,955 | $13K | |
| 90716 | <1% | 4,266 | $13K | |
| 90734 | <1% | 2,084 | $12K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 240 | $12K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 878 | $11K |
| 90461 | <1% | 19,121 | $11K | |
| 85018 | <1% | 4,810 | $10K | |
| 69210 | <1% | 214 | $8K | |
| 90707 | <1% | 4,233 | $7K | |
| 99384 | <1% | 82 | $7K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 3,182 | $6K |
| 36416 | <1% | 3,797 | $4K | |
| 90723 | <1% | 6,788 | $4K | |
| 81003 | <1% | 1,955 | $3K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 204 | $3K |
| 90620 | <1% | 230 | $3K | |
| 90633 | <1% | 4,526 | $2K | |
| 90681 | <1% | 2,875 | $2K | |
| 90715 | <1% | 1,058 | $2K | |
| 90674 | <1% | 1,158 | $2K | |
| 90696 | <1% | 1,337 | $2K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 46 | $1K |
| 99188 | <1% | 4,641 | $1K | |
| 90647 | <1% | 6,769 | $1K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 28 | $1K |
| 87430 | <1% | 143 | $1K | |
| 87400 | <1% | 145 | $1K | |
| 96380 | <1% | 63 | $951.82 | |
| 99382 | <1% | 54 | $934.80 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $852.19 |
| 87807 | <1% | 80 | $749.17 | |
| 0072A | <1% | 18 | $720.00 | |
| 90686 | <1% | 5,596 | $684.89 | |
| 90700 | <1% | 1,209 | $469.64 | |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 662 | $371.05 |
| 99462 | <1% | 12 | $256.33 | |
| 99174 | <1% | 16 | $202.91 | |
| 90656 | <1% | 718 | $173.73 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 12 | $168.62 |
| 94760 | <1% | 207 | $122.53 | |
| 81025 | <1% | 13 | $79.15 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 790 | $68.02 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 40 | $60.74 |
| 90685 | <1% | 135 | $25.50 | |
| 90688 | <1% | 1,172 | $18.00 | |
| 91307 | <1% | 266 | $16.74 | |
| 90381 | <1% | 33 | $0.01 | |
| 90687 | 0% | 232 | $0.00 | |
| 99000 | 0% | 3,544 | $0.00 | |
| 90744 | 0% | 16 | $0.00 | |
| 90698 | 0% | 50 | $0.00 | |
| 90660 | 0% | 20 | $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 officialJORDAN, CHARLES (PHYSICIAN)
| Provider | Location | Paid |
|---|---|---|
| Mcleod Physician Associates II | Darlington, SC | $155K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.