Physician
Asheville Children's Medical Center, P.A.
Asheville Children's Medical Center, P.A. was paid $9.31M by Medicaid between Jan 2018 and Dec 2024, across 80 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 28% of everything it billed.
33Billing provider infoASHEVILLE CHILDREN'S MEDICAL CENTER, P.A.
ASHEVILLE, NC 28803
ASHEVILLE, NC 28803
33aNPI1538128194assigned 03/22/2006
33bProvider typePediatrics Physician
28Total paid$9.31M
24GClaims419,462
24DCodes billed80
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#37 of 433
Median peer was paid$942K
This provider vs. median9.9×
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 | 25,329 | $882K | |
| 2019 | 26,175 | $1.11M | |
| 2020 | 21,207 | $966K | |
| 2021 | 55,739 | $1.41M | |
| 2022 | 110,495 | $1.94M | |
| 2023 | 104,282 | $1.73M | |
| 2024incomplete | 76,235 | $1.28M |
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 | 28% | 27,638 | 24,241 | $2.60M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 22% | 32,328 | 28,141 | $2.07M |
| 99199 | Unlisted special service, procedure or report | 11% | 228,414 | 128,663 | $1.06M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.5% | 13,252 | 11,648 | $609K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.1% | 6,305 | 5,270 | $571K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.0% | 5,770 | 5,120 | $554K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.6% | 4,431 | 3,995 | $424K |
| 99050 | 3.6% | 13,548 | 11,892 | $340K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.9% | 2,598 | 2,322 | $268K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 2.0% | 5,116 | 4,466 | $186K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.2% | 8,319 | 7,555 | $113K |
| 87428 | <1% | 2,434 | 1,861 | $87K |
68 more codes
| 99401 | <1% | 3,811 | $84K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,539 | $68K |
| 96127 | <1% | 11,507 | $53K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 4,243 | $40K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,056 | $30K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 987 | $27K |
| 90651 | <1% | 1,139 | $19K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 517 | $17K |
| 90461 | <1% | 6,869 | $15K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 538 | $11K |
| D1206 | Topical application of fluoride varnish | <1% | 512 | $7K |
| 90734 | <1% | 515 | $6K | |
| 0071A | <1% | 109 | $5K | |
| 0072A | <1% | 99 | $5K | |
| 83655 | <1% | 319 | $5K | |
| 90480 | <1% | 126 | $4K | |
| 96161 | <1% | 2,131 | $4K | |
| 0001A | <1% | 104 | $4K | |
| 0002A | <1% | 82 | $3K | |
| 0124A | <1% | 49 | $3K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 183 | $2K |
| 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) | <1% | 854 | $2K |
| 36415 | Collection of venous blood by venipuncture | <1% | 889 | $2K |
| 90620 | <1% | 103 | $1K | |
| 99243 | <1% | 15 | $1K | |
| 99442 | <1% | 66 | $1K | |
| 99173 | <1% | 6,901 | $1K | |
| 0154A | <1% | 41 | $1K | |
| 92551 | <1% | 2,660 | $958.30 | |
| 99441 | <1% | 82 | $957.18 | |
| 0111A | <1% | 14 | $915.86 | |
| 81002 | <1% | 277 | $807.18 | |
| 92552 | <1% | 1,940 | $758.91 | |
| 90474 | <1% | 27 | $432.00 | |
| 90715 | <1% | 212 | $406.68 | |
| 90633 | <1% | 996 | $313.43 | |
| 96160 | <1% | 81 | $228.86 | |
| 90619 | <1% | 176 | $173.79 | |
| 85013 | <1% | 165 | $160.62 | |
| 90723 | <1% | 1,500 | $140.00 | |
| 90686 | <1% | 5,413 | $54.68 | |
| 90670 | 0% | 2,396 | $0.00 | |
| 90681 | 0% | 226 | $0.00 | |
| 90685 | 0% | 179 | $0.00 | |
| 99072 | 0% | 679 | $0.00 | |
| 90648 | 0% | 2,253 | $0.00 | |
| 90710 | 0% | 267 | $0.00 | |
| 91311 | 0% | 115 | $0.00 | |
| 90658 | 0% | 379 | $0.00 | |
| 91300 | 0% | 267 | $0.00 | |
| J1055 | 0% | 78 | $0.00 | |
| 90700 | 0% | 58 | $0.00 | |
| 90621 | 0% | 59 | $0.00 | |
| 90707 | 0% | 16 | $0.00 | |
| 91312 | 0% | 40 | $0.00 | |
| 90677 | 0% | 247 | $0.00 | |
| G0136 | Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months | 0% | 312 | $0.00 |
| 90697 | 0% | 145 | $0.00 | |
| 91307 | 0% | 364 | $0.00 | |
| 90696 | 0% | 152 | $0.00 | |
| 91319 | 0% | 16 | $0.00 | |
| 91315 | 0% | 40 | $0.00 | |
| 90680 | 0% | 37 | $0.00 | |
| 91305 | 0% | 14 | $0.00 | |
| 90656 | 0% | 44 | $0.00 | |
| 90716 | 0% | 40 | $0.00 | |
| 91318 | 0% | 27 | $0.00 | |
| 94760 | 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 officialKOWA, KAREN (INSURANCE COORDINATOR)