Southern Gastroenterology Associates PC
Southern Gastroenterology Associates PC was paid $887K by Medicaid between Feb 2018 and Dec 2024, across 15 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 31% of everything it billed.
33Billing provider infoSOUTHERN GASTROENTEROLOGY ASSOCIATES PC
SOUTH BOSTON, VA 24592
SOUTH BOSTON, VA 24592
33aNPI1376659870assigned 08/21/2006
33bProvider typeSpecialist
28Total paid$887K
24GClaims16,172
24DCodes billed15
24AFirst – last monthFeb 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in Virginia
Rank by total paid#28 of 231
Median peer was paid$47K
This provider vs. median19×
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 | 1,257 | $24K | |
| 2019 | 2,375 | $87K | |
| 2020 | 1,962 | $103K | |
| 2021 | 2,723 | $161K | |
| 2022 | 3,072 | $183K | |
| 2023 | 2,788 | $197K | |
| 2024incomplete | 1,995 | $132K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 31% | 4,931 | 4,319 | $273K |
| 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% | 5,419 | 4,907 | $224K |
| 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 | 14% | 1,292 | 1,220 | $121K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 13% | 1,931 | 1,682 | $115K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 7.0% | 610 | 563 | $62K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 4.8% | 478 | 440 | $43K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 1.5% | 105 | 96 | $13K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.4% | 197 | 190 | $12K |
| 43249 | <1% | 139 | 122 | $9K | |
| 44377 | <1% | 27 | 26 | $6K | |
| 99205 | Prolong outpt/office vis | <1% | 25 | 24 | $3K |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | <1% | 696 | 613 | $2K |
3 more codes
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 officialPALMER, NICOLE (PRACTICE MANAGER)