Southern Medical Management, LLC

Southern Medical Management, LLC was paid $43.86M by Medicaid between Jan 2018 and Dec 2024, across 82 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.

33Billing provider infoSOUTHERN MEDICAL MANAGEMENT, LLC
LEXINGTON, SC 29072

33aNPI1114196557assigned 02/28/2008

33bProvider typePediatrics Physician

28Total paid$43.86M

24GClaims870,099

24DCodes billed82

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pediatrics Physician providers in South Carolina

Rank by total paid#1 of 471

Median peer was paid$18K

This provider vs. median2,485×

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	79,795	$3.16M
2019	81,595	$3.51M
2020	99,024	$4.34M
2021	136,904	$6.80M
2022	155,327	$8.58M
2023	183,597	$10.06M
2024incomplete	133,857	$7.41M

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	24%	158,690	146,230	$10.72M
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	21%	96,282	89,916	$9.29M
90460	Immunization administration through 18 years of age via any route, first or only component	9.8%	78,626	77,059	$4.29M
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	8.3%	36,668	36,188	$3.66M
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	7.1%	33,819	31,846	$3.11M
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	6.0%	26,063	25,808	$2.61M
90837	Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient	5.2%	21,656	12,433	$2.29M
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	3.2%	12,701	12,558	$1.40M
G9153	Mapcp demonstration - physician incentive pool	2.7%	23,894	23,786	$1.18M
87428		2.2%	16,136	15,642	$976K
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	2.0%	18,142	17,527	$882K
90461		1.5%	24,487	23,878	$650K

70 more codes

87804	Infectious agent antigen detection by immunoassay; Influenza, each type	1.1%	34,579	$463K
96127		<1%	35,359	$239K
90791	Psychiatric diagnostic evaluation	<1%	1,421	$217K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	14,419	$193K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	<1%	7,759	$191K
99460		<1%	2,203	$173K
99238	Hospital discharge day management, 30 minutes or less	<1%	1,841	$113K
87430		<1%	8,221	$108K
99174		<1%	19,238	$102K
99381		<1%	925	$97K
83655		<1%	7,987	$95K
99499		<1%	1,267	$95K
92551		<1%	19,624	$86K
90834	Psychotherapy session, about 45 minutes	<1%	1,030	$74K
99051		<1%	5,859	$68K
99188		<1%	4,241	$68K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	8,619	$65K
0241U	Neonatal screening for hereditary disorders, genomic sequence analysis panel	<1%	487	$61K
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	6,759	$49K
87807		<1%	3,805	$43K
96161		<1%	5,122	$39K
99203	Doctor's office visit, new patient (routine)	<1%	432	$37K
99204	Doctor's office visit, new patient (more involved)	<1%	217	$29K
81002		<1%	8,536	$25K
87400		<1%	982	$11K
90832	Psychotherapy session, about 30 minutes	<1%	279	$10K
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	495	$6K
85018		<1%	2,231	$5K
90833	Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on)	<1%	226	$5K
99383		<1%	43	$5K
36415	Collection of venous blood by venipuncture	<1%	1,515	$4K
82465		<1%	1,076	$4K
96131		<1%	12	$3K
90677		<1%	3,800	$3K
99382		<1%	27	$3K
99462		<1%	48	$2K
81003		<1%	845	$2K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	12	$1K
90651		<1%	3,432	$1K
83718		<1%	197	$1K
99199	Unlisted special service, procedure or report	<1%	490	$1K
96130		<1%	12	$1K
90670		<1%	18,532	$967.90
99402		<1%	16	$828.21
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	<1%	33	$757.13
90716		<1%	7,557	$673.20
95117		<1%	65	$493.20
90686		<1%	14,179	$356.19
90707		<1%	7,917	$279.98
90723		<1%	15,480	$265.57
96380		<1%	13	$227.03
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	244	$214.89
90715		<1%	722	$165.08
86308		<1%	32	$159.94
90734		<1%	2,226	$156.20
90696		<1%	1,143	$124.00
90633		<1%	8,253	$107.92
96160		<1%	12	$85.97
87081		<1%	17	$80.36
90648		<1%	20,792	$23.06
90656		<1%	389	$20.64
99173		<1%	1,828	$10.37
90620		0%	253	$0.00
90647		0%	971	$0.00
90744		0%	63	$0.00
90680		0%	113	$0.00
90698		0%	134	$0.00
90681		0%	4,635	$0.00
90700		0%	1,595	$0.00
90685		0%	49	$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 officialGUYTON, R. (PHYSICIAN)