Physician
Raleigh Pediatric Associates, PA
Raleigh Pediatric Associates, PA was paid $7.73M by Medicaid between Jan 2018 and Dec 2024, across 49 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 40% of everything it billed.
33Billing provider infoRALEIGH PEDIATRIC ASSOCIATES, PA
RALEIGH, NC 27615
RALEIGH, NC 27615
33aNPI1508941535assigned 10/26/2006
33bProvider typePediatrics Physician
28Total paid$7.73M
24GClaims429,987
24DCodes billed49
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#54 of 433
Median peer was paid$942K
This provider vs. median8.2×
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.
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 | 20,481 | $712K | |
| 2019 | 19,771 | $799K | |
| 2020 | 16,354 | $637K | |
| 2021 | 54,009 | $1.11M | |
| 2022 | 104,419 | $1.56M | |
| 2023 | 100,236 | $1.49M | |
| 2024incomplete | 114,717 | $1.43M |
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 | 40% | 49,479 | 39,956 | $3.11M |
| 99199 | Unlisted special service, procedure or report | 21% | 283,652 | 173,266 | $1.65M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 22,386 | 19,812 | $855K |
| 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 | 7.6% | 6,339 | 5,191 | $585K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.9% | 5,032 | 4,523 | $459K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.3% | 2,833 | 2,460 | $258K |
| 87631 | 3.0% | 2,946 | 2,238 | $228K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.5% | 1,975 | 1,688 | $194K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.3% | 5,083 | 4,450 | $101K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 6,377 | 5,640 | $57K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 1,668 | 1,544 | $53K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,217 | 1,060 | $29K |
37 more codes
| D1206 | Topical application of fluoride varnish | <1% | 1,666 | $23K |
| 0072A | <1% | 286 | $19K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 158 | $17K |
| 0071A | <1% | 255 | $16K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 339 | $13K |
| 90686 | <1% | 7,618 | $13K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 863 | $11K |
| 99051 | <1% | 461 | $11K | |
| 0002A | <1% | 152 | $9K | |
| 0001A | <1% | 107 | $6K | |
| 96127 | <1% | 759 | $3K | |
| 90651 | <1% | 76 | $3K | |
| 96161 | <1% | 1,261 | $2K | |
| 87081 | <1% | 289 | $2K | |
| 92552 | <1% | 3,286 | $1K | |
| 0052A | <1% | 24 | $1K | |
| 0082A | <1% | 20 | $1K | |
| 0054A | <1% | 19 | $799.08 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 21 | $388.55 |
| 99173 | <1% | 4,767 | $380.16 | |
| 90656 | <1% | 654 | $221.83 | |
| 99000 | <1% | 7,853 | $6.50 | |
| 90698 | 0% | 830 | $0.00 | |
| 4037F | 0% | 4,448 | $0.00 | |
| 36416 | 0% | 412 | $0.00 | |
| 90680 | 0% | 356 | $0.00 | |
| 90697 | 0% | 166 | $0.00 | |
| 90677 | 0% | 123 | $0.00 | |
| 90744 | 0% | 38 | $0.00 | |
| 91307 | 0% | 648 | $0.00 | |
| 91305 | 0% | 45 | $0.00 | |
| 90685 | 0% | 386 | $0.00 | |
| 90670 | 0% | 1,064 | $0.00 | |
| 91308 | 0% | 87 | $0.00 | |
| 91300 | 0% | 200 | $0.00 | |
| 99177 | 0% | 193 | $0.00 | |
| 90633 | 0% | 70 | $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 officialBERNSTEIN, JERRY (PHYSICIAN OWNER)