Clinic
Piedmont Health Services, INC
Piedmont Health Services, INC was paid $6.22M by Medicaid between Jan 2018 and Dec 2024, across 36 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 60% of everything it billed.
33Billing provider infoPIEDMONT HEALTH SERVICES, INC
BURLINGTON, NC 27217
BURLINGTON, NC 27217
33aNPI1588768527assigned 09/11/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$6.22M
24GClaims418,361
24DCodes billed36
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in North Carolina
Rank by total paid#13 of 324
Median peer was paid$279K
This provider vs. median22×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official TOOMEY, BRIAN controls 12+ related entities in our dataset. Read more
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 | 16,488 | $976K | |
| 2019 | 16,943 | $1.03M | |
| 2020 | 12,994 | $796K | |
| 2021 | 39,450 | $802K | |
| 2022 | 92,736 | $554K | |
| 2023 | 108,055 | $651K | |
| 2024incomplete | 131,695 | $1.41M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 60% | 34,787 | 28,640 | $3.74M |
| 99199 | Unlisted special service, procedure or report | 32% | 353,750 | 182,819 | $2.00M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.6% | 1,565 | 1,238 | $98K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.5% | 1,280 | 1,192 | $95K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.4% | 1,137 | 1,035 | $86K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 2,763 | 2,510 | $61K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 4,096 | 3,647 | $43K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 432 | 389 | $31K |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | <1% | 833 | 719 | $18K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 2,454 | 1,975 | $16K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 265 | 251 | $9K |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 938 | 849 | $8K |
24 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 173 | $7K |
| D1206 | Topical application of fluoride varnish | <1% | 395 | $6K |
| 96160 | <1% | 1,790 | $3K | |
| 99381 | <1% | 32 | $1K | |
| 0012A | <1% | 12 | $715.00 | |
| 90734 | <1% | 39 | $276.08 | |
| 96161 | <1% | 252 | $259.07 | |
| 99401 | <1% | 166 | $131.76 | |
| 92551 | <1% | 3,303 | $105.27 | |
| 99173 | <1% | 3,683 | $59.00 | |
| 90670 | 0% | 1,269 | $0.00 | |
| 90633 | 0% | 321 | $0.00 | |
| 90707 | 0% | 150 | $0.00 | |
| 90715 | 0% | 16 | $0.00 | |
| 90700 | 0% | 14 | $0.00 | |
| 90680 | 0% | 379 | $0.00 | |
| 90723 | 0% | 752 | $0.00 | |
| 90645 | 0% | 754 | $0.00 | |
| 3008F | 0% | 196 | $0.00 | |
| 90716 | 0% | 197 | $0.00 | |
| 90656 | 0% | 78 | $0.00 | |
| 90651 | 0% | 19 | $0.00 | |
| 91301 | 0% | 54 | $0.00 | |
| 90696 | 0% | 17 | $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 officialTOOMEY, BRIAN (CEO)
| Provider | Location | Paid |
|---|---|---|
| Piedmont Health Services, INC | Carrboro, NC | $16.87M |
| Piedmont Health Services, INC | Burlington, NC | $3.31M |
| Piedmont Health Services, INC | Burlington, NC | $2.76M |
| Piedmont Health Services, INC | Siler City, NC | $2.00M |
| Piedmont Health Services, INC | Prospect Hill, NC | $1.99M |
| Piedmont Health Services, INC. | Carrboro, NC | $678K |
| Piedmont Health Services, INC. | Snow Camp, NC | $544K |
| Piedmont Health Services, INC | Moncure, NC | $470K |
| Piedmont Health Services, INC. | Siler City, NC | $228K |
| Piedmont Health Services, INC. | Prospect Hill, NC | $127K |
| Piedmont Health Services, INC | Carrboro, NC | $11K |
| Piedmont Health Services, INC | Carrboro, NC | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.