Behavioral
Colonial Family Practice, LLC
Colonial Family Practice, LLC was paid $9.48M by Medicaid between Jan 2018 and Dec 2024, across 174 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 49% of everything it billed.
33Billing provider infoCOLONIAL FAMILY PRACTICE, LLC
SUMTER, SC 29150
SUMTER, SC 29150
33aNPI1518074640assigned 08/24/2006
33bProvider typeCounselor
28Total paid$9.48M
24GClaims497,566
24DCodes billed174
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Counselor providers in South Carolina
Rank by total paid#2 of 56
Median peer was paid$137K
This provider vs. median69×
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 | 40,750 | $1.27M | |
| 2019 | 27,935 | $933K | |
| 2020 | 31,821 | $957K | |
| 2021 | 99,377 | $1.82M | |
| 2022 | 125,783 | $2.01M | |
| 2023 | 91,014 | $1.51M | |
| 2024incomplete | 80,886 | $978K |
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 | 49% | 90,344 | 76,856 | $4.68M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 24% | 52,957 | 48,485 | $2.32M |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 4.1% | 3,129 | 3,053 | $392K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.3% | 5,170 | 4,960 | $223K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.3% | 2,823 | 2,760 | $220K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.8% | 3,958 | 3,842 | $171K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 1.8% | 3,245 | 1,896 | $167K |
| 87428 | 1.4% | 3,220 | 3,094 | $133K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.1% | 4,996 | 4,453 | $104K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.1% | 4,319 | 4,247 | $104K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 781 | 764 | $55K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 10,536 | 9,946 | $51K |
162 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 7,272 | $51K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 5,032 | $50K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 7,609 | $45K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 1,493 | $44K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 563 | $42K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 511 | $38K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 1,891 | $31K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | <1% | 302 | $29K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 420 | $29K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 2,498 | $29K |
| 80061 | Lipid panel | <1% | 3,931 | $29K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 474 | $28K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 438 | $27K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 411 | $25K |
| 80076 | <1% | 4,897 | $24K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 14,975 | $23K |
| 99335 | <1% | 374 | $21K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 210 | $18K |
| 99490 | Ccm add 20min | <1% | 3,086 | $16K |
| G9153 | Mapcp demonstration - physician incentive pool | <1% | 650 | $14K |
| 82610 | <1% | 971 | $13K | |
| 83735 | <1% | 2,616 | $12K | |
| 94060 | <1% | 495 | $11K | |
| 82607 | <1% | 1,199 | $10K | |
| 99336 | <1% | 146 | $9K | |
| 84439 | <1% | 1,716 | $9K | |
| 90461 | <1% | 1,042 | $9K | |
| 84681 | <1% | 841 | $9K | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 293 | $9K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 792 | $8K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 242 | $7K |
| 82746 | <1% | 899 | $7K | |
| 99407 | <1% | 431 | $7K | |
| 81001 | <1% | 3,827 | $6K | |
| 87807 | <1% | 901 | $6K | |
| 82550 | <1% | 1,807 | $6K | |
| 85018 | <1% | 3,821 | $6K | |
| 82962 | <1% | 6,335 | $5K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 738 | $5K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 103 | $5K |
| 99406 | <1% | 697 | $4K | |
| 87081 | <1% | 994 | $4K | |
| 95911 | <1% | 71 | $4K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 147 | $4K |
| 90686 | <1% | 681 | $4K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 142 | $4K |
| 95886 | <1% | 79 | $4K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 300 | $4K |
| 81003 | <1% | 2,559 | $4K | |
| 92551 | <1% | 966 | $3K | |
| 84100 | <1% | 1,421 | $3K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 2,061 | $3K |
| 93000 | <1% | 363 | $3K | |
| 20611 | <1% | 260 | $3K | |
| 83615 | <1% | 978 | $3K | |
| 20610 | <1% | 199 | $3K | |
| 85027 | <1% | 505 | $3K | |
| 82728 | <1% | 266 | $2K | |
| 90756 | <1% | 89 | $2K | |
| 81025 | <1% | 385 | $2K | |
| 84481 | <1% | 188 | $2K | |
| 84550 | <1% | 794 | $2K | |
| 90674 | <1% | 132 | $2K | |
| 64493 | <1% | 54 | $2K | |
| 84403 | <1% | 104 | $1K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 676 | $1K |
| 93923 | <1% | 50 | $1K | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 223 | $1K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,459 | $1K |
| 82044 | <1% | 319 | $1K | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 276 | $921.24 |
| 80305 | <1% | 193 | $763.43 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 119 | $739.58 |
| 95924 | <1% | 25 | $705.83 | |
| 96127 | <1% | 89 | $686.36 | |
| 99051 | <1% | 66 | $672.00 | |
| 84153 | <1% | 70 | $639.98 | |
| 83540 | <1% | 169 | $614.90 | |
| 82947 | <1% | 141 | $609.09 | |
| 64494 | <1% | 41 | $599.36 | |
| 95923 | <1% | 21 | $598.70 | |
| 86431 | <1% | 193 | $527.63 | |
| 83550 | <1% | 92 | $448.84 | |
| 93922 | <1% | 13 | $446.54 | |
| 64495 | <1% | 26 | $399.87 | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 21 | $362.60 |
| 86308 | <1% | 111 | $342.03 | |
| 0011A | <1% | 13 | $340.76 | |
| 93040 | <1% | 84 | $321.90 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 235 | $309.76 |
| 83701 | <1% | 12 | $264.03 | |
| 85652 | <1% | 218 | $250.16 | |
| 90694 | <1% | 56 | $235.58 | |
| G8482 | Influenza immunization administered or previously received | <1% | 2,053 | $150.00 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 15 | $132.30 |
| A9577 | Injection, gadobenate dimeglumine (multihance), per ml | <1% | 13 | $107.64 |
| 83655 | <1% | 13 | $98.28 | |
| 90661 | <1% | 13 | $63.62 | |
| 82043 | <1% | 29 | $55.70 | |
| 85651 | <1% | 16 | $48.96 | |
| 90662 | <1% | 33 | $45.80 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 12 | $38.95 |
| 82570 | <1% | 16 | $32.69 | |
| 90651 | <1% | 208 | $10.31 | |
| 1160F | <1% | 16,338 | $1.19 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | <1% | 17,761 | $0.85 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 46,644 | $0.79 |
| 1126F | <1% | 5,402 | $0.11 | |
| 90715 | <1% | 27 | $0.10 | |
| 3077F | <1% | 704 | $0.01 | |
| 90619 | <1% | 15 | $0.01 | |
| 3078F | 0% | 14,303 | $0.00 | |
| 1159F | 0% | 9,583 | $0.00 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 489 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 5,317 | $0.00 |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 1,843 | $0.00 |
| 0521F | 0% | 5,775 | $0.00 | |
| 3288F | 0% | 72 | $0.00 | |
| 3725F | 0% | 325 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 823 | $0.00 |
| 90633 | 0% | 292 | $0.00 | |
| 4004F | 0% | 682 | $0.00 | |
| 90670 | 0% | 227 | $0.00 | |
| 90734 | 0% | 53 | $0.00 | |
| G9899 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed | 0% | 173 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 231 | $0.00 |
| 1100F | 0% | 72 | $0.00 | |
| 2028F | 0% | 27 | $0.00 | |
| G8404 | Lower extremity neurological exam performed and documented | 0% | 27 | $0.00 |
| 90653 | 0% | 29 | $0.00 | |
| G9744 | Patient not eligible due to active diagnosis of hypertension | 0% | 24 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 43 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 66 | $0.00 |
| 1036F | 0% | 9,314 | $0.00 | |
| 3008F | 0% | 4,493 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 18,680 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 14,515 | $0.00 |
| 1125F | 0% | 6,301 | $0.00 | |
| 3074F | 0% | 14,631 | $0.00 | |
| 3079F | 0% | 1,461 | $0.00 | |
| 3017F | 0% | 612 | $0.00 | |
| 3044F | 0% | 753 | $0.00 | |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 1,123 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 592 | $0.00 |
| G9664 | Patients who are currently statin therapy users or received an order (prescription) for statin therapy | 0% | 930 | $0.00 |
| 1111F | 0% | 113 | $0.00 | |
| 3080F | 0% | 126 | $0.00 | |
| 1034F | 0% | 565 | $0.00 | |
| 4037F | 0% | 594 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 423 | $0.00 |
| 3075F | 0% | 642 | $0.00 | |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 234 | $0.00 |
| 90698 | 0% | 39 | $0.00 | |
| 3014F | 0% | 185 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 68 | $0.00 |
| 3061F | 0% | 43 | $0.00 | |
| 90677 | 0% | 27 | $0.00 | |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 57 | $0.00 |
| G8542 | Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required | 0% | 30 | $0.00 |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | 0% | 14 | $0.00 |
| 90744 | 0% | 25 | $0.00 | |
| 90680 | 0% | 12 | $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 officialLOWDER, CLAYTON (MD/CEO)