Southside Medical Center, INC.

Southside Medical Center, INC. was paid $28.82M by Medicaid between Jan 2018 and Dec 2024, across 190 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 28% of everything it billed.

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	103,651	$4.67M
2019	109,068	$4.98M
2020	80,836	$4.07M
2021	72,449	$3.65M
2022	84,750	$4.33M
2023	150,455	$3.91M
2024incomplete	151,591	$3.21M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	28%	85,293	70,513	$8.19M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	25%	75,339	63,223	$7.15M
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	9.8%	30,844	27,850	$2.82M
D0999	Unspecified diagnostic procedure, by report	7.4%	29,751	21,216	$2.13M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	4.0%	47,714	2,009	$1.14M
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	2.5%	6,451	5,946	$725K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	2.4%	6,147	5,982	$703K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.4%	6,046	5,954	$684K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	2.1%	5,221	5,114	$603K
D0150	Comprehensive oral evaluation - new or established patient	2.0%	12,455	11,456	$580K
90460	Immunization administration through 18 years of age via any route, first or only component	1.5%	17,987	17,412	$430K
D0140	Limited oral evaluation - problem focused	1.4%	8,688	6,326	$402K

178 more codes

D0220	Intraoral - periapical first radiographic image	<1%	17,406	$221K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	2,430	$210K
D7140	Extraction, erupted tooth or exposed root	<1%	5,361	$206K
99203	Doctor's office visit, new patient (routine)	<1%	2,322	$203K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	2,085	$197K
59409	Vaginal delivery only (with or without episiotomy and/or forceps)	<1%	279	$185K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	1,766	$170K
D1120	Dental cleaning, child	<1%	5,991	$156K
D1110	Prophylaxis - adult	<1%	3,683	$137K
90837	Psychotherapy session, about an hour	<1%	1,772	$120K
99383		<1%	1,144	$119K
99384		<1%	1,007	$103K
D1206	Topical application of fluoride varnish	<1%	5,114	$101K
D0330	Panoramic radiographic image	<1%	2,424	$99K
99381		<1%	1,060	$96K
D1351	Sealant - per tooth	<1%	3,900	$80K
99215	Doctor's office visit, returning patient (complex)	<1%	889	$80K
99173		<1%	18,373	$65K
92551		<1%	16,374	$60K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	<1%	621	$54K
D0120	Dental checkup, returning patient	<1%	1,309	$47K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	551	$46K
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	3,961	$38K
99382		<1%	369	$35K
90832	Psychotherapy session, about 30 minutes	<1%	1,091	$33K
S0621	Routine ophthalmological examination including refraction; established patient	<1%	258	$25K
T1003	Lpn/lvn services, up to 15 minutes	<1%	1,348	$22K
99050		<1%	968	$22K
D1208	Topical application of fluoride, excluding varnish	<1%	3,905	$20K
99385		<1%	238	$20K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	<1%	342	$17K
D0230	Intraoral - periapical each additional radiographic image	<1%	11,116	$17K
D0274	Bitewings - four radiographic images	<1%	5,511	$16K
99204	Doctor's office visit, new patient (more involved)	<1%	193	$16K
86008		<1%	70	$14K
90853	Group psychotherapy (other than of a multiple-family group)	<1%	716	$12K
90834	Psychotherapy session, about 45 minutes	<1%	234	$12K
81025		<1%	13,917	$11K
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	161	$10K
D0272	Bitewings - two radiographic images	<1%	2,490	$9K
D7111		<1%	100	$7K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	<1%	138	$7K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	<1%	178	$7K
90671		<1%	684	$7K
92340	Fitting of spectacles, except for aphakia; monofocal	<1%	501	$6K
90791	Psychiatric diagnostic evaluation	<1%	53	$6K
99078		<1%	117	$6K
0001A		<1%	160	$6K
90651		<1%	2,876	$6K
Q3014	Telehealth originating site facility fee	<1%	599	$6K
81002		<1%	28,921	$5K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	694	$5K
90792	Psychiatric diagnostic evaluation with medical services	<1%	64	$5K
90472	Immunization administration, each additional vaccine (list separately)	<1%	202	$5K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	635	$4K
99386		<1%	38	$4K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	513	$4K
99283	Emergency room visit (moderate)	<1%	54	$3K
V2020	Frames, purchases	<1%	304	$3K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	<1%	75	$2K
96127		<1%	10,452	$2K
11721		<1%	2,029	$2K
90715		<1%	1,370	$2K
76801		<1%	475	$2K
0002A		<1%	58	$2K
T1002	Rn services, up to 15 minutes	<1%	108	$2K
99205	Prolong outpt/office vis	<1%	20	$2K
H0031	Mental health assessment, by non-physician	<1%	40	$2K
3078F		<1%	18,441	$2K
99429		<1%	983	$2K
0011A		<1%	52	$2K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	<1%	13	$1K
96161		<1%	706	$1K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	<1%	373	$1K
3079F		<1%	6,082	$1K
92283		<1%	86	$1K
99188		<1%	183	$1K
90686		<1%	1,889	$1K
59025	Fetal non-stress test	<1%	43	$1K
90670		<1%	3,691	$1K
J1050	Injection, medroxyprogesterone acetate, 1 mg	<1%	27	$1K
91300		<1%	376	$961.51
H0032	Mental health service plan development by non-physician	<1%	15	$905.65
90785		<1%	329	$888.09
92227		<1%	53	$863.08
0012A		<1%	26	$840.00
3074F		<1%	19,737	$829.86
90734		<1%	1,903	$689.50
3075F		<1%	2,118	$675.94
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	<1%	16,626	$665.51
76856	Ultrasound, pelvic (nonobstetric), real time with image documentation; complete	<1%	184	$664.72
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	328	$629.60
V2025	Deluxe frame	<1%	32	$600.00
S0620	Routine ophthalmological examination including refraction; new patient	<1%	16	$598.00
82962		<1%	4,517	$592.25
20610		<1%	19	$569.30
36415	Collection of venous blood by venipuncture	<1%	162	$505.80
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	<1%	51	$434.16
90620		<1%	905	$418.22
0031A		<1%	25	$360.00
90674		<1%	55	$240.00
36410		<1%	17	$185.97
G0467	Community health center visit, returning patient	<1%	2,852	$183.06
90756		<1%	45	$170.00
91301		<1%	130	$160.17
A4267	Contraceptive supply, condom, male, each	<1%	153	$126.28
90656		<1%	33	$124.45
90723		<1%	2,681	$124.12
83655		<1%	214	$117.00
87210		<1%	398	$116.88
3077F		<1%	1,681	$91.41
85018		<1%	726	$85.22
3080F		<1%	1,302	$76.31
11055		<1%	14	$56.85
87420		<1%	52	$45.24
90633		<1%	2,482	$40.93
99402		<1%	66	$40.50
36416		<1%	183	$28.00
11056		<1%	54	$25.23
90647		<1%	2,510	$21.77
90700		<1%	412	$11.77
1160F		<1%	15,331	$10.00
92015	Determination of refractive state	<1%	13	$10.00
96160		<1%	243	$1.37
3008F		<1%	21,556	$0.08
2010F		<1%	30,255	$0.08
2022F		<1%	12	$0.01
90680		0%	533	$0.00
2001F		0%	24,375	$0.00
90716		0%	558	$0.00
1126F		0%	4,442	$0.00
1125F		0%	1,531	$0.00
99350	Prolong home eval add 15m	0%	49	$0.00
1220F		0%	7,444	$0.00
99024		0%	98	$0.00
1170F		0%	65	$0.00
J1100	Injection, dexamethasone sodium phosphate, 1 mg	0%	261	$0.00
90619		0%	458	$0.00
87490		0%	25	$0.00
90697		0%	473	$0.00
93000		0%	54	$0.00
1036F		0%	13	$0.00
90696		0%	541	$0.00
V2784	Lens, polycarbonate or equal, any index, per lens	0%	13	$0.00
76830	Ultrasound, transvaginal	0%	97	$0.00
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	13	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	0%	26	$0.00
76811	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed	0%	110	$0.00
91303		0%	29	$0.00
99495		0%	13	$0.00
97802		0%	42	$0.00
G8432	Depression screening not documented, reason not given	0%	13	$0.00
90698		0%	13	$0.00
91307		0%	12	$0.00
87590		0%	13	$0.00
90649		0%	197	$0.00
90710		0%	775	$0.00
1159F		0%	16,003	$0.00
90681		0%	551	$0.00
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	0%	265	$0.00
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month	0%	961	$0.00
90707		0%	489	$0.00
1100F		0%	1,826	$0.00
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit	0%	14	$0.00
G8483	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	0%	233	$0.00
G0444	Annual depression screening, 5 to 15 minutes	0%	70	$0.00
G9920	Screening performed and negative	0%	46	$0.00
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	0%	96	$0.00
90713		0%	17	$0.00
20552		0%	27	$0.00
85014		0%	39	$0.00
82948		0%	29	$0.00
G8484	Influenza immunization was not administered, reason not given	0%	87	$0.00
83037		0%	38	$0.00
D1203		0%	29	$0.00
D4341		0%	63	$0.00
76805	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation	0%	14	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	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 officialKASSA, MASRESHA (CFO)