Pediatric Associates, P.A.

Pediatric Associates, P.A. was paid $7.60M by Medicaid between Jan 2018 and Dec 2024, across 72 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 33% of everything it billed.

33Billing provider infoPEDIATRIC ASSOCIATES, P.A.
COLUMBIA, SC 29204

33aNPI1447383666assigned 03/14/2007

33bProvider typePreferred Provider Organization

28Total paid$7.60M

24GClaims229,408

24DCodes billed72

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Preferred Provider Organization providers in South Carolina

Rank by total paid#1 of 7

Median peer was paid$452K

This provider vs. median17×

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	34,963	$888K
2019	29,342	$829K
2020	27,806	$830K
2021	36,823	$1.24M
2022	37,540	$1.32M
2023	35,354	$1.34M
2024incomplete	27,580	$1.16M

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	33%	38,622	34,356	$2.49M
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	14%	11,184	10,264	$1.04M
90460	Immunization administration through 18 years of age via any route, first or only component	10.0%	16,927	16,619	$759K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	8.4%	6,444	6,387	$640K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	7.5%	6,171	6,049	$567K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	5.1%	3,881	3,843	$385K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	2.9%	5,628	4,873	$219K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	2.7%	1,864	1,852	$202K
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	2.2%	3,316	3,202	$164K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	1.9%	11,595	11,063	$148K
90461		1.9%	6,576	6,392	$141K
87502	Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets	1.6%	1,650	1,582	$125K

60 more codes

85025	Blood count; complete (CBC), automated, and automated differential WBC count	1.3%	13,256	$96K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	1.1%	5,635	$81K
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	9,577	$75K
36415	Collection of venous blood by venipuncture	<1%	19,941	$47K
87811	Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19)	<1%	1,122	$43K
99215	Doctor's office visit, returning patient (complex)	<1%	345	$41K
99050		<1%	3,600	$40K
96127		<1%	4,626	$37K
99238	Hospital discharge day management, 30 minutes or less	<1%	534	$34K
87081		<1%	4,522	$28K
85018		<1%	10,378	$25K
96160		<1%	3,346	$20K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	1,080	$20K
81003		<1%	8,591	$19K
87634		<1%	283	$16K
87430		<1%	952	$14K
83655		<1%	1,073	$14K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	<1%	155	$8K
82465		<1%	2,046	$8K
99233	Hospital visit by a doctor, follow-up day (complex)	<1%	76	$7K
87807		<1%	684	$7K
99223	Prolong inpt eval add15 m	<1%	38	$7K
90677		<1%	666	$6K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	1,585	$6K
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	503	$5K
99460		<1%	51	$4K
G9153	Mapcp demonstration - physician incentive pool	<1%	95	$4K
94664		<1%	228	$2K
0071A		<1%	65	$2K
0072A		<1%	43	$1K
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	956	$1K
0002A		<1%	29	$870.00
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	<1%	32	$776.14
90686		<1%	4,331	$529.23
90380		<1%	17	$511.43
94760		<1%	329	$463.21
69210		<1%	12	$457.34
87301		<1%	47	$413.47
0003A		<1%	13	$390.00
99058		<1%	13	$325.00
82247		<1%	61	$291.22
90723		<1%	2,745	$186.32
90633		<1%	1,707	$104.97
90656		<1%	237	$77.16
90648		<1%	3,226	$48.52
91307		<1%	150	$2.59
91300		<1%	36	$0.35
90696		0%	69	$0.00
36416		0%	1,332	$0.00
90651		0%	164	$0.00
90716		0%	118	$0.00
90620		0%	13	$0.00
90670		0%	3,333	$0.00
90734		0%	248	$0.00
90681		0%	964	$0.00
90707		0%	93	$0.00
90700		0%	41	$0.00
90710		0%	85	$0.00
90715		0%	25	$0.00
90685		0%	28	$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 officialCASTLES, CHARLES (PRESIDENT)