Physician
South Carolina Pediatrics Alliance, LLC
South Carolina Pediatrics Alliance, LLC was paid $63.42M by Medicaid between Jan 2018 and Dec 2024, across 102 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 26% of everything it billed.
33Billing provider infoSOUTH CAROLINA PEDIATRICS ALLIANCE, LLC
COLUMBIA, SC 29229
COLUMBIA, SC 29229
33aNPI1184016941assigned 03/03/2015
33bProvider typePediatric Adolescent Medicine Physician
28Total paid$63.42M
24GClaims1,496,176
24DCodes billed102
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Adolescent Medicine Physician providers in South Carolina
Rank by total paid#1 of 24
Median peer was paid$76K
This provider vs. median829×
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 | 203,280 | $7.10M | |
| 2019 | 182,528 | $6.94M | |
| 2020 | 184,365 | $7.45M | |
| 2021 | 226,623 | $10.39M | |
| 2022 | 238,845 | $11.06M | |
| 2023 | 255,326 | $11.44M | |
| 2024incomplete | 205,209 | $9.04M |
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 | 26% | 246,045 | 223,988 | $16.30M |
| 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% | 139,772 | 129,226 | $13.38M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.2% | 59,514 | 58,101 | $5.85M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.0% | 55,414 | 52,848 | $5.07M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 7.9% | 161,524 | 152,603 | $5.00M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.5% | 36,014 | 35,018 | $3.51M |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.6% | 15,413 | 14,884 | $1.66M |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.4% | 31,869 | 30,604 | $1.55M |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 2.3% | 18,640 | 17,980 | $1.45M |
| G9153 | Mapcp demonstration - physician incentive pool | 2.1% | 26,118 | 25,996 | $1.33M |
| 90461 | 1.9% | 71,109 | 69,118 | $1.21M | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.2% | 15,250 | 14,656 | $756K |
90 more codes
| 99188 | <1% | 40,315 | $614K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 73,736 | $547K |
| 96127 | <1% | 75,462 | $513K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 32,393 | $439K |
| 99460 | <1% | 5,179 | $434K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 32,224 | $433K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 9,964 | $400K |
| 87428 | <1% | 5,792 | $348K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 5,306 | $347K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 12,465 | $345K |
| 96161 | <1% | 42,722 | $335K | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 22,689 | $269K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 1,525 | $154K |
| 85018 | <1% | 67,434 | $153K | |
| 87634 | <1% | 1,938 | $111K | |
| 80061 | Lipid panel | <1% | 8,901 | $97K |
| 99401 | <1% | 2,884 | $91K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 10,425 | $77K |
| 99051 | <1% | 6,565 | $75K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 1,292 | $73K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 1,251 | $63K |
| 99177 | <1% | 14,261 | $60K | |
| 99462 | <1% | 1,625 | $56K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 2,764 | $55K |
| 83655 | <1% | 2,746 | $34K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 771 | $31K |
| 0071A | <1% | 747 | $29K | |
| 81003 | <1% | 7,540 | $18K | |
| 0001A | <1% | 386 | $15K | |
| 87807 | <1% | 1,311 | $14K | |
| 0072A | <1% | 330 | $13K | |
| 90480 | <1% | 410 | $13K | |
| 96160 | <1% | 1,651 | $12K | |
| 94010 | <1% | 498 | $12K | |
| 86769 | <1% | 267 | $11K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 106 | $9K |
| 82247 | <1% | 1,638 | $9K | |
| 0002A | <1% | 220 | $9K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 129 | $8K |
| 85013 | <1% | 1,720 | $5K | |
| H2000 | Comprehensive multidisciplinary evaluation | <1% | 26 | $4K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 29 | $3K |
| 90686 | <1% | 28,862 | $3K | |
| 90677 | <1% | 3,698 | $3K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 265 | $3K |
| 0124A | <1% | 79 | $2K | |
| 96380 | <1% | 132 | $2K | |
| 90656 | <1% | 2,488 | $2K | |
| 99383 | <1% | 12 | $1K | |
| 97802 | <1% | 49 | $1K | |
| 90670 | <1% | 17,739 | $1K | |
| A4627 | Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler | <1% | 33 | $1K |
| 0154A | <1% | 24 | $880.00 | |
| 0081A | <1% | 25 | $840.00 | |
| 3008F | <1% | 9,857 | $491.41 | |
| 90651 | <1% | 1,129 | $442.88 | |
| 36416 | <1% | 11,911 | $368.34 | |
| 0121A | <1% | 16 | $360.00 | |
| 90698 | <1% | 15,266 | $335.41 | |
| 94760 | <1% | 321 | $282.47 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 72 | $231.15 |
| 99050 | <1% | 13 | $159.30 | |
| 90648 | <1% | 3,703 | $104.86 | |
| 90680 | <1% | 9,797 | $91.74 | |
| 90685 | <1% | 1,016 | $73.44 | |
| 82465 | <1% | 17 | $60.57 | |
| 91300 | <1% | 365 | $55.13 | |
| 90633 | <1% | 4,459 | $33.21 | |
| 90744 | <1% | 2,555 | $25.46 | |
| 90700 | <1% | 174 | $21.33 | |
| 99072 | <1% | 906 | $15.00 | |
| 91307 | <1% | 1,225 | $11.15 | |
| 91308 | <1% | 126 | $1.14 | |
| 91312 | <1% | 75 | $0.70 | |
| 90381 | <1% | 70 | $0.60 | |
| 90619 | <1% | 174 | $0.54 | |
| 91319 | <1% | 29 | $0.15 | |
| 91315 | <1% | 12 | $0.12 | |
| 91318 | <1% | 14 | $0.09 | |
| 90723 | <1% | 2,260 | $0.08 | |
| 90688 | <1% | 17 | $0.06 | |
| 90734 | <1% | 213 | $0.01 | |
| 90696 | 0% | 15 | $0.00 | |
| 99426 | 0% | 157 | $0.00 | |
| 99000 | 0% | 62 | $0.00 | |
| 90716 | 0% | 31 | $0.00 | |
| 90687 | 0% | 228 | $0.00 | |
| 90715 | 0% | 114 | $0.00 | |
| 90707 | 0% | 39 | $0.00 | |
| 90713 | 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 officialGRUBBS, SARAH (CFO)