Clinic
Karen L Smith MD, PA
Karen L Smith MD, PA was paid $1.13M by Medicaid between Jan 2018 and Dec 2024, across 46 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 73% of everything it billed.
33Billing provider infoKAREN L SMITH MD, PA
RAEFORD, NC 28376
RAEFORD, NC 28376
33aNPI1609066158assigned 07/31/2007
33bProvider typePrimary Care Clinic/Center
28Total paid$1.13M
24GClaims81,242
24DCodes billed46
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in North Carolina
Rank by total paid#25 of 116
Median peer was paid$226K
This provider vs. median5.0×
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 | 5,861 | $143K | |
| 2019 | 5,583 | $192K | |
| 2020 | 4,175 | $159K | |
| 2021 | 6,855 | $166K | |
| 2022 | 11,496 | $172K | |
| 2023 | 22,797 | $146K | |
| 2024incomplete | 24,475 | $153K |
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 | 73% | 14,705 | 10,529 | $828K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12% | 3,082 | 2,272 | $137K |
| 99199 | Unlisted special service, procedure or report | 8.3% | 24,654 | 16,611 | $94K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.1% | 275 | 211 | $24K |
| 99490 | Ccm add 20min | 1.2% | 1,378 | 1,350 | $14K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.1% | 203 | 166 | $13K |
| 81002 | <1% | 4,655 | 3,689 | $7K | |
| 96161 | <1% | 1,123 | 791 | $3K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 104 | 80 | $2K |
| 99408 | <1% | 89 | 59 | $2K | |
| 80305 | <1% | 176 | 108 | $2K | |
| 0011A | <1% | 33 | 30 | $1K |
34 more codes
| 99497 | <1% | 728 | $1K | |
| 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% | 518 | $1K |
| 81025 | <1% | 352 | $948.48 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 131 | $891.39 |
| 94060 | <1% | 29 | $829.04 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 83 | $752.53 |
| 93000 | <1% | 45 | $424.18 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 95 | $407.15 |
| 92551 | <1% | 218 | $104.26 | |
| 90658 | <1% | 83 | $35.61 | |
| 99173 | <1% | 198 | $17.27 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 15 | $2.24 |
| 1036F | 0% | 3,042 | $0.00 | |
| 3008F | 0% | 4,561 | $0.00 | |
| 1035F | 0% | 124 | $0.00 | |
| 1125F | 0% | 1,299 | $0.00 | |
| 3075F | 0% | 1,281 | $0.00 | |
| 3079F | 0% | 1,842 | $0.00 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 0% | 560 | $0.00 |
| 1034F | 0% | 1,788 | $0.00 | |
| 3074F | 0% | 2,563 | $0.00 | |
| 1126F | 0% | 1,299 | $0.00 | |
| 3080F | 0% | 590 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 517 | $0.00 |
| 99443 | 0% | 174 | $0.00 | |
| 91301 | 0% | 31 | $0.00 | |
| 3288F | 0% | 118 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 1,078 | $0.00 |
| 3725F | 0% | 739 | $0.00 | |
| 3078F | 0% | 2,045 | $0.00 | |
| 1160F | 0% | 3,245 | $0.00 | |
| 1100F | 0% | 695 | $0.00 | |
| 3077F | 0% | 634 | $0.00 | |
| 99442 | 0% | 45 | $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 officialSMITH, KAREN (PHYSICIAN/OWNER)
| Provider | Location | Paid |
|---|---|---|
| Insight, INC. | Woodbridge, VA | $60.72M |
| The ARC of Greater Prince William/Insight | Woodbridge, VA | $10.77M |
| Alden Medical Supply LLC | Alden, NY | $2.18M |
| All Care Home and Community Services | Itmann, WV | $1.54M |
| Shelby Pediatrics, LLC | Sidney, OH | $250K |
| Karen Smith LCSW LLC | Milford, CT | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.