Gateway Children's

Gateway Children's was paid $283K by Medicaid between Jan 2018 and Jun 2018, across 6 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 70% of everything it billed.

33Billing provider infoGATEWAY CHILDREN'S
SPARTANBURG, SC 29303

33aNPI1275900961assigned 08/28/2015

33bProvider typePediatrics Physician

28Total paid$283K

24GClaims6,343

24DCodes billed6

24AFirst – last monthJan 2018 – Jun 2018

Compared with peers

Next to other Pediatrics Physician providers in South Carolina

Rank by total paid#77 of 471

Median peer was paid$18K

This provider vs. median16×

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	6,343	$283K

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	70%	5,201	2,157	$199K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	12%	360	353	$35K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	7.5%	364	325	$21K
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	6.6%	220	200	$19K
90887		3.0%	130	121	$8K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	68	68	$1K

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 officialKNOX-FRAZIER, TONYA (CEO)