Southern Orthopedic Associates SC
Southern Orthopedic Associates SC was paid $3.15M by Medicaid between Jan 2018 and Mar 2022, across 54 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 19% of everything it billed.
33Billing provider infoSOUTHERN ORTHOPEDIC ASSOCIATES SC
HERRIN, IL 62948
HERRIN, IL 62948
33aNPI1396792412assigned 05/27/2006
33bProvider typePhysical Therapist
28Total paid$3.15M
24GClaims81,372
24DCodes billed54
24AFirst – last monthJan 2018 – Mar 2022
Compared with peers
Next to other Physical Therapist providers in Illinois
Rank by total paid#4 of 690
Median peer was paid$9K
This provider vs. median334×
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 | 21,398 | $1.01M | |
| 2019 | 25,797 | $1.04M | |
| 2020 | 19,565 | $710K | |
| 2021 | 12,165 | $311K | |
| 2022 | 2,447 | $67K |
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 | 19% | 31,069 | 25,511 | $609K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | 19% | 4,320 | 3,870 | $608K |
| 62323 | 8.6% | 2,615 | 2,152 | $270K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 8.0% | 6,882 | 5,933 | $252K |
| 64635 | 7.0% | 1,199 | 801 | $220K | |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | 6.8% | 2,429 | 1,953 | $214K |
| 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 | 5.8% | 6,337 | 5,191 | $183K |
| 64636 | 4.9% | 1,983 | 781 | $155K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 3.8% | 5,194 | 1,627 | $120K |
| 64493 | 2.2% | 630 | 458 | $69K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.6% | 1,196 | 1,059 | $52K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 1.5% | 411 | 384 | $46K |
42 more codes
| 99243 | 1.3% | 482 | $40K | |
| 20610 | 1.2% | 1,703 | $39K | |
| 64494 | 1.0% | 633 | $33K | |
| 62321 | <1% | 256 | $28K | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 3,042 | $27K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 444 | $26K |
| 64495 | <1% | 374 | $21K | |
| 73630 | <1% | 1,561 | $20K | |
| 99406 | <1% | 3,421 | $17K | |
| 72110 | <1% | 816 | $15K | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | <1% | 72 | $13K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 218 | $10K |
| 27096 | <1% | 50 | $10K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,183 | $9K |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | <1% | 34 | $7K |
| 73564 | <1% | 275 | $4K | |
| 64483 | <1% | 34 | $4K | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 770 | $4K |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | <1% | 277 | $3K |
| 72100 | <1% | 256 | $3K | |
| 20930 | <1% | 31 | $2K | |
| 97161 | <1% | 62 | $2K | |
| 72050 | <1% | 109 | $2K | |
| 22853 | <1% | 49 | $2K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 284 | $2K |
| 73610 | <1% | 86 | $1K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 137 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 104 | $1K |
| 97162 | <1% | 13 | $505.90 | |
| 73110 | <1% | 49 | $485.73 | |
| 77002 | <1% | 15 | $480.15 | |
| 97022 | <1% | 55 | $340.28 | |
| 73502 | <1% | 15 | $240.24 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 18 | $186.48 |
| 99442 | <1% | 27 | $170.29 | |
| 73030 | <1% | 12 | $167.97 | |
| 73560 | <1% | 12 | $153.02 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 66 | $115.29 |
| 99441 | <1% | 15 | $85.27 | |
| 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% | 19 | $69.83 |
| 36415 | Collection of venous blood by venipuncture | <1% | 15 | $41.83 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 13 | $3.31 |
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 officialDAVIS, JOHN (PRESIDENT ORTHOPEDIC SURGEON)
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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.