NP / PA
Elm Pediatrics, LLC
Elm Pediatrics, LLC was paid $1.36M by Medicaid between Apr 2022 and Dec 2024, across 33 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 52% of everything it billed.
33Billing provider infoELM PEDIATRICS, LLC
LAKE CITY, SC 29560
LAKE CITY, SC 29560
33aNPI1255009163assigned 09/03/2021
33bProvider typeFamily Nurse Practitioner
28Total paid$1.36M
24GClaims38,268
24DCodes billed33
24AFirst – last monthApr 2022 – Dec 2024
Compared with peers
Next to other Family Nurse Practitioner providers in South Carolina
Rank by total paid#5 of 207
Median peer was paid$3K
This provider vs. median534×
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 | |
|---|---|---|---|
| 2022 | 6,678 | $202K | |
| 2023 | 15,147 | $493K | |
| 2024incomplete | 16,443 | $660K |
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 | 52% | 12,337 | 10,277 | $699K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 2,830 | 2,712 | $143K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 7.9% | 2,376 | 2,207 | $108K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.9% | 1,415 | 1,378 | $107K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.7% | 1,241 | 1,225 | $105K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 4.2% | 5,288 | 4,748 | $56K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.8% | 3,781 | 1,718 | $39K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.3% | 502 | 496 | $31K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.9% | 302 | 278 | $26K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.4% | 3,029 | 2,958 | $19K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 72 | 62 | $7K |
| 99381 | <1% | 71 | 69 | $7K |
21 more codes
| 87807 | <1% | 514 | $5K | |
| 96161 | <1% | 405 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 37 | $776.43 |
| 85018 | <1% | 330 | $605.26 | |
| 90677 | <1% | 561 | $288.66 | |
| 81002 | <1% | 67 | $185.32 | |
| 99188 | <1% | 27 | $184.14 | |
| 96127 | <1% | 26 | $88.02 | |
| 90670 | 0% | 500 | $0.00 | |
| 90700 | 0% | 263 | $0.00 | |
| 90633 | 0% | 379 | $0.00 | |
| 90461 | 0% | 26 | $0.00 | |
| 90713 | 0% | 66 | $0.00 | |
| 90710 | 0% | 49 | $0.00 | |
| 90707 | 0% | 46 | $0.00 | |
| 90648 | 0% | 39 | $0.00 | |
| 90744 | 0% | 386 | $0.00 | |
| 90698 | 0% | 738 | $0.00 | |
| 90716 | 0% | 55 | $0.00 | |
| 90680 | 0% | 494 | $0.00 | |
| 90686 | 0% | 16 | $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 officialBROWN, HEATHER (PRACTICE ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Hope on the Lakeshore Therapy Professional LLC | Whitehall, MI | $120K |
| Community Inclusion INC | Jamestown, NY | $56K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.