Physician
Novant Health Medical Group, LLC
Novant Health Medical Group, LLC was paid $1.13M by Medicaid between Jan 2018 and Dec 2024, across 36 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 20% of everything it billed.
33Billing provider infoNOVANT HEALTH MEDICAL GROUP, LLC
DENVER, NC 28037
DENVER, NC 28037
33aNPI1396295465assigned 10/12/2016
33bProvider typePediatrics Physician
28Total paid$1.13M
24GClaims67,885
24DCodes billed36
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#203 of 433
Median peer was paid$942K
This provider vs. median1.2×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official WALTON, LEEA controls 20+ related entities in our dataset. Read more
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 | 5,157 | $127K | |
| 2019 | 1,964 | $82K | |
| 2020 | 2,262 | $91K | |
| 2021 | 6,527 | $182K | |
| 2022 | 16,627 | $330K | |
| 2023 | 18,948 | $274K | |
| 2024incomplete | 16,400 | $42K |
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 | 20% | 3,827 | 2,888 | $230K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 18% | 2,397 | 1,828 | $202K |
| 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 | 16% | 2,062 | 1,640 | $185K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 12% | 3,344 | 2,609 | $139K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10% | 1,196 | 957 | $113K |
| 99199 | Unlisted special service, procedure or report | 9.8% | 37,906 | 37,025 | $111K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.0% | 3,946 | 3,229 | $34K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.6% | 932 | 877 | $18K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.5% | 621 | 602 | $16K |
| D0145 | Oral evaluation for a patient under three years of age | 1.2% | 382 | 341 | $14K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 157 | 126 | $9K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 500 | 383 | $8K |
24 more codes
| 96127 | <1% | 1,821 | $8K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 262 | $7K |
| D1206 | Topical application of fluoride varnish | <1% | 382 | $6K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 97 | $5K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 51 | $5K |
| 96161 | <1% | 1,255 | $4K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 45 | $4K |
| 90474 | <1% | 200 | $4K | |
| 90461 | <1% | 1,765 | $2K | |
| 99383 | <1% | 14 | $1K | |
| 99381 | <1% | 13 | $1K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 75 | $680.18 |
| 90686 | <1% | 489 | $213.75 | |
| 92551 | <1% | 170 | $30.18 | |
| 90674 | <1% | 219 | $20.45 | |
| 92552 | <1% | 97 | $16.47 | |
| 99173 | <1% | 269 | $15.08 | |
| 90670 | 0% | 1,335 | $0.00 | |
| 90648 | 0% | 303 | $0.00 | |
| 90633 | 0% | 74 | $0.00 | |
| 90744 | 0% | 177 | $0.00 | |
| 90723 | 0% | 154 | $0.00 | |
| 90698 | 0% | 608 | $0.00 | |
| 90680 | 0% | 740 | $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 officialWALTON, LEEA (RCS MANAGER)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.