Physician
Pinehurst Medical Clinic, INC.
Pinehurst Medical Clinic, INC. was paid $5.60M by Medicaid between Jan 2018 and Dec 2024, across 106 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 21% of everything it billed.
33Billing provider infoPINEHURST MEDICAL CLINIC, INC.
PINEHURST, NC 28374
PINEHURST, NC 28374
33aNPI1255388369assigned 05/27/2006
33bProvider typeFamily Medicine Physician
28Total paid$5.60M
24GClaims291,740
24DCodes billed106
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in North Carolina
Rank by total paid#11 of 960
Median peer was paid$135K
This provider vs. median41×
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 | 14,641 | $539K | |
| 2019 | 13,072 | $596K | |
| 2020 | 9,715 | $366K | |
| 2021 | 27,522 | $613K | |
| 2022 | 56,883 | $906K | |
| 2023 | 70,383 | $1.05M | |
| 2024incomplete | 99,524 | $1.53M |
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 | 21% | 27,052 | 22,390 | $1.18M |
| 99199 | Unlisted special service, procedure or report | 20% | 184,247 | 110,661 | $1.12M |
| 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 | 17% | 22,707 | 19,165 | $959K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 14% | 4,524 | 3,814 | $763K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 6.6% | 1,310 | 1,145 | $368K |
| 95811 | 4.0% | 986 | 824 | $222K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.5% | 1,367 | 1,196 | $87K |
| 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 | 1.4% | 878 | 741 | $81K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 1.4% | 1,228 | 950 | $80K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.4% | 4,931 | 3,788 | $79K |
| 94729 | <1% | 4,951 | 4,179 | $52K | |
| 88342 | <1% | 1,518 | 1,209 | $46K |
94 more codes
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 470 | $38K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,694 | $34K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,400 | $34K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 860 | $31K |
| 94618 | <1% | 2,894 | $30K | |
| 94375 | <1% | 2,998 | $29K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 178 | $25K |
| 94726 | <1% | 2,065 | $25K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 591 | $24K |
| 87428 | <1% | 355 | $21K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 200 | $18K |
| 95806 | <1% | 119 | $14K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 3,946 | $13K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,623 | $13K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 844 | $11K |
| 94060 | <1% | 574 | $11K | |
| 71250 | <1% | 176 | $11K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 124 | $10K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 88 | $10K |
| 86003 | <1% | 55 | $8K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 117 | $8K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 237 | $7K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,121 | $7K |
| 93880 | <1% | 134 | $7K | |
| 95827 | <1% | 54 | $7K | |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 51 | $7K |
| 94010 | <1% | 793 | $7K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 115 | $6K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 51 | $6K |
| 80053 | Comprehensive metabolic panel | <1% | 727 | $6K |
| 88312 | <1% | 249 | $6K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 663 | $5K |
| 99443 | <1% | 140 | $5K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 324 | $5K |
| 99442 | <1% | 172 | $5K | |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | <1% | 73 | $5K |
| 99441 | <1% | 161 | $3K | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 1,356 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 179 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 77 | $2K |
| 80061 | Lipid panel | <1% | 194 | $2K |
| 88313 | <1% | 247 | $2K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 43 | $2K |
| 94762 | <1% | 195 | $2K | |
| 85027 | <1% | 263 | $2K | |
| 93017 | <1% | 144 | $2K | |
| 95819 | <1% | 15 | $2K | |
| 90686 | <1% | 1,125 | $2K | |
| 84481 | <1% | 87 | $2K | |
| 84439 | <1% | 179 | $2K | |
| 86140 | <1% | 286 | $1K | |
| 82785 | <1% | 93 | $1K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 132 | $1K |
| 93296 | <1% | 104 | $1K | |
| 85651 | <1% | 304 | $1K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 139 | $1K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 33 | $990.57 |
| 90661 | <1% | 116 | $979.50 | |
| J2785 | Injection, regadenoson, 0.1 mg | <1% | 27 | $950.91 |
| 96127 | <1% | 294 | $793.71 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 34 | $715.00 |
| 99490 | Ccm add 20min | <1% | 27 | $648.92 |
| 93000 | <1% | 59 | $571.54 | |
| 82607 | <1% | 34 | $553.48 | |
| 86431 | <1% | 91 | $520.48 | |
| 82784 | <1% | 45 | $468.42 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 16 | $456.12 |
| 43450 | <1% | 21 | $447.74 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 49 | $391.32 |
| 82728 | <1% | 27 | $363.26 | |
| 92551 | <1% | 226 | $337.32 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 163 | $303.55 |
| 84436 | <1% | 52 | $293.39 | |
| 87807 | <1% | 22 | $279.57 | |
| 80076 | <1% | 47 | $272.94 | |
| 90474 | <1% | 13 | $265.85 | |
| 87077 | <1% | 29 | $260.01 | |
| 90674 | <1% | 179 | $241.84 | |
| 92552 | <1% | 21 | $239.99 | |
| 99173 | <1% | 1,327 | $223.73 | |
| D1206 | Topical application of fluoride varnish | <1% | 17 | $218.14 |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 58 | $171.98 |
| 96161 | <1% | 43 | $138.38 | |
| 83550 | <1% | 13 | $120.69 | |
| 83540 | <1% | 13 | $89.46 | |
| 99406 | <1% | 16 | $75.90 | |
| 81003 | <1% | 16 | $36.10 | |
| 99177 | <1% | 29 | $15.66 | |
| 1159F | <1% | 32 | $0.01 | |
| 99000 | 0% | 51 | $0.00 | |
| 90680 | 0% | 13 | $0.00 | |
| 3008F | 0% | 15 | $0.00 | |
| 90670 | 0% | 142 | $0.00 | |
| 90685 | 0% | 33 | $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 officialENFINGER, BRANDON (CEO)
| Provider | Location | Paid |
|---|---|---|
| Pinehurst Medical Clinic INC | Pinehurst, NC | $985K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.