Physician
Edgewater Medical Center and Urgent
Edgewater Medical Center and Urgent was paid $1.86M by Medicaid between Jan 2018 and Jun 2024, across 54 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 47% of everything it billed.
33Billing provider infoEDGEWATER MEDICAL CENTER AND URGENT
LILLINGTON, NC 27546
LILLINGTON, NC 27546
33aNPI1205865979assigned 07/03/2006
33bProvider typePediatrics Physician
28Total paid$1.86M
24GClaims169,707
24DCodes billed54
24AFirst – last monthJan 2018 – Jun 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#167 of 433
Median peer was paid$942K
This provider vs. median2.0×
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 | 10,046 | $166K | |
| 2019 | 14,244 | $216K | |
| 2020 | 17,768 | $252K | |
| 2021 | 21,012 | $326K | |
| 2022 | 39,744 | $353K | |
| 2023 | 42,746 | $365K | |
| 2024incomplete | 24,147 | $183K |
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 | 47% | 16,990 | 11,417 | $880K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 9,756 | 6,629 | $354K |
| 99199 | Unlisted special service, procedure or report | 16% | 49,651 | 30,167 | $294K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 11% | 1,918 | 1,493 | $201K |
| 99406 | <1% | 2,923 | 1,988 | $18K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 241 | 186 | $17K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,790 | 670 | $16K |
| 99401 | <1% | 1,439 | 1,033 | $11K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,246 | 1,530 | $10K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 200 | 127 | $9K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 892 | 684 | $9K |
| 99051 | <1% | 447 | 349 | $8K |
42 more codes
| 93000 | <1% | 874 | $7K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 947 | $7K |
| 81002 | <1% | 3,340 | $5K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 27 | $3K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 232 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 347 | $2K |
| 96127 | <1% | 656 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 91 | $1K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 21 | $1K |
| 96160 | <1% | 483 | $964.90 | |
| 90686 | <1% | 106 | $800.35 | |
| 90682 | <1% | 69 | $779.80 | |
| 81025 | <1% | 141 | $672.80 | |
| 90688 | <1% | 94 | $604.95 | |
| 99407 | <1% | 26 | $324.56 | |
| 87905 | <1% | 19 | $197.04 | |
| 83037 | <1% | 545 | $159.97 | |
| 87808 | <1% | 18 | $155.43 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 336 | $99.79 |
| 80305 | <1% | 16 | $91.03 | |
| 3044F | <1% | 1,346 | $60.00 | |
| 99497 | <1% | 25 | $16.01 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 19 | $6.40 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 24 | $3.12 |
| 3008F | <1% | 12,427 | $1.29 | |
| 3074F | <1% | 12,515 | $1.01 | |
| 3077F | 0% | 4,382 | $0.00 | |
| 3078F | 0% | 11,713 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 6,616 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 295 | $0.00 |
| 90662 | 0% | 14 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 311 | $0.00 |
| 1034F | 0% | 3,737 | $0.00 | |
| 1036F | 0% | 6,575 | $0.00 | |
| 3075F | 0% | 2,667 | $0.00 | |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | 0% | 1,958 | $0.00 |
| 3079F | 0% | 4,634 | $0.00 | |
| 99000 | 0% | 219 | $0.00 | |
| 3080F | 0% | 2,938 | $0.00 | |
| 1111F | 0% | 55 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 78 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 278 | $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 officialREYES, RODOLFO (OWNER/MANAGER)
Parent organizationEDGEWATER MEDICAL CENTER AND URGENT
| Provider | Location | Paid |
|---|---|---|
| Universal Medical Associates, PLLC | Raleigh, NC | $1.52M |
| Med Mart Medical Associates PLLC | Holly Springs, NC | $1.29M |
| Health Zone PLLC | Smithfield, NC | $903K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.