Clinic
Oconee Pediatrics
Oconee Pediatrics was paid $8.52M by Medicaid between Jan 2018 and Dec 2024, across 49 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 38% of everything it billed.
33Billing provider infoOCONEE PEDIATRICS
SENECA, SC 29678
SENECA, SC 29678
33aNPI1629049127assigned 02/01/2006
33bProvider typeRural Health Clinic/Center
28Total paid$8.52M
24GClaims148,515
24DCodes billed49
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in South Carolina
Rank by total paid#1 of 81
Median peer was paid$302K
This provider vs. median28×
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 | 14,721 | $928K | |
| 2019 | 17,276 | $962K | |
| 2020 | 16,608 | $814K | |
| 2021 | 24,970 | $1.21M | |
| 2022 | 26,176 | $1.52M | |
| 2023 | 27,112 | $1.63M | |
| 2024incomplete | 21,652 | $1.46M |
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 | 38% | 32,734 | 26,296 | $3.21M |
| 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% | 20,807 | 17,664 | $2.00M |
| 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 | 8.8% | 7,410 | 6,810 | $750K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 5.6% | 4,118 | 3,935 | $477K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.6% | 4,014 | 3,958 | $396K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.9% | 3,420 | 3,349 | $335K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.8% | 3,395 | 3,325 | $327K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.9% | 2,538 | 2,489 | $248K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.8% | 11,214 | 6,599 | $239K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 9,703 | 9,112 | $122K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.3% | 2,272 | 2,153 | $113K |
| 96127 | 1.3% | 14,532 | 12,379 | $108K |
37 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 3,167 | $47K |
| G9153 | Mapcp demonstration - physician incentive pool | <1% | 750 | $45K |
| 90461 | <1% | 1,659 | $16K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 2,067 | $15K |
| 81003 | <1% | 6,962 | $13K | |
| 83655 | <1% | 1,182 | $13K | |
| 99499 | <1% | 140 | $10K | |
| 80061 | Lipid panel | <1% | 491 | $5K |
| 96161 | <1% | 951 | $5K | |
| 87807 | <1% | 515 | $5K | |
| 81002 | <1% | 1,084 | $5K | |
| 85018 | <1% | 1,722 | $4K | |
| 96160 | <1% | 1,558 | $3K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 13 | $1K |
| 0072A | <1% | 12 | $480.00 | |
| 90651 | <1% | 241 | $264.35 | |
| 90710 | <1% | 517 | $220.84 | |
| 92552 | <1% | 1,191 | $202.32 | |
| 86308 | <1% | 42 | $188.58 | |
| 90670 | <1% | 914 | $185.25 | |
| 90723 | <1% | 996 | $77.27 | |
| 90633 | <1% | 738 | $57.46 | |
| 90647 | <1% | 970 | $25.69 | |
| 90686 | <1% | 941 | $16.42 | |
| 94760 | <1% | 26 | $7.84 | |
| 90681 | 0% | 205 | $0.00 | |
| 90734 | 0% | 302 | $0.00 | |
| G8709 | Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne) | 0% | 528 | $0.00 |
| 90715 | 0% | 118 | $0.00 | |
| 99173 | 0% | 320 | $0.00 | |
| 90700 | 0% | 25 | $0.00 | |
| G8708 | Patient not prescribed antibiotic | 0% | 962 | $0.00 |
| 36416 | 0% | 509 | $0.00 | |
| 90696 | 0% | 95 | $0.00 | |
| 90677 | 0% | 330 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 103 | $0.00 |
| 90620 | 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 officialSTEWART, FRANK (BUSINESS OWNER)
| Provider | Location | Paid |
|---|---|---|
| Oconee Pediatrics | Seneca, SC | $98K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.