Physician
Pirate Pediatrics, PA
Pirate Pediatrics, PA was paid $2.32M by Medicaid between Jan 2018 and Dec 2024, across 53 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 25% of everything it billed.
33Billing provider infoPIRATE PEDIATRICS, PA
GREENVILLE, NC 27858
GREENVILLE, NC 27858
33aNPI1265719512assigned 11/14/2011
33bProvider typePediatrics Physician
28Total paid$2.32M
24GClaims171,520
24DCodes billed53
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#144 of 433
Median peer was paid$942K
This provider vs. median2.5×
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 | 6,220 | $192K | |
| 2019 | 7,889 | $244K | |
| 2020 | 6,559 | $211K | |
| 2021 | 17,401 | $290K | |
| 2022 | 40,111 | $420K | |
| 2023 | 46,714 | $508K | |
| 2024incomplete | 46,626 | $456K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 25% | 113,942 | 42,438 | $586K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 20% | 8,345 | 7,423 | $456K |
| 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% | 4,939 | 4,472 | $399K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 5,626 | 5,286 | $234K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.1% | 1,979 | 1,918 | $165K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.3% | 1,527 | 1,437 | $122K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.9% | 806 | 751 | $67K |
| D0145 | Oral evaluation for a patient under three years of age | 2.3% | 1,646 | 1,607 | $52K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.9% | 4,784 | 4,569 | $44K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.2% | 2,229 | 1,025 | $28K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.2% | 792 | 732 | $27K |
| D1206 | Topical application of fluoride varnish | 1.0% | 1,849 | 1,807 | $24K |
41 more codes
| 96127 | <1% | 2,996 | $18K | |
| 92552 | <1% | 1,303 | $16K | |
| 90837 | Psychotherapy session, about an hour | <1% | 154 | $12K |
| 99070 | <1% | 1,192 | $10K | |
| 90461 | <1% | 2,242 | $8K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 518 | $7K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 73 | $7K |
| 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% | 1,073 | $6K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 270 | $5K |
| 0072A | <1% | 57 | $3K | |
| 99173 | <1% | 2,659 | $3K | |
| 96161 | <1% | 800 | $3K | |
| 0071A | <1% | 51 | $3K | |
| 99401 | <1% | 98 | $3K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 226 | $2K |
| 96160 | <1% | 589 | $2K | |
| 90686 | <1% | 1,921 | $2K | |
| 99051 | <1% | 95 | $1K | |
| 94664 | <1% | 125 | $1K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 19 | $1K |
| 99441 | <1% | 52 | $1K | |
| 90480 | <1% | 12 | $780.00 | |
| 87807 | <1% | 63 | $775.84 | |
| 92551 | <1% | 1,324 | $612.11 | |
| 83655 | <1% | 17 | $253.81 | |
| 91307 | <1% | 137 | $128.28 | |
| 83718 | <1% | 15 | $121.20 | |
| 85018 | <1% | 42 | $108.39 | |
| 90656 | <1% | 163 | $78.21 | |
| 82465 | <1% | 15 | $64.32 | |
| 90647 | <1% | 427 | $29.52 | |
| 90633 | <1% | 124 | $0.01 | |
| 90670 | 0% | 922 | $0.00 | |
| 90707 | 0% | 110 | $0.00 | |
| 90681 | 0% | 27 | $0.00 | |
| 91300 | 0% | 14 | $0.00 | |
| 90716 | 0% | 100 | $0.00 | |
| 36416 | 0% | 939 | $0.00 | |
| 90723 | 0% | 493 | $0.00 | |
| 99000 | 0% | 1,519 | $0.00 | |
| 90677 | 0% | 80 | $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 officialMORGAN, CAROLINE (OWNER/PEDIATRICIAN)