Physician
Legacy Pediatrics
Legacy Pediatrics was paid $2.81M by Medicaid between Jan 2018 and May 2024, across 63 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 27% of everything it billed.
33Billing provider infoLEGACY PEDIATRICS
FAYETTEVILLE, NC 28304
FAYETTEVILLE, NC 28304
33aNPI1699903542assigned 06/30/2009
33bProvider typePediatrics Physician
28Total paid$2.81M
24GClaims132,245
24DCodes billed63
24AFirst – last monthJan 2018 – May 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#128 of 433
Median peer was paid$942K
This provider vs. median3.0×
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 | 9,308 | $258K | |
| 2019 | 9,017 | $297K | |
| 2020 | 7,304 | $261K | |
| 2021 | 19,288 | $406K | |
| 2022 | 36,931 | $660K | |
| 2023 | 36,605 | $705K | |
| 2024incomplete | 13,792 | $227K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 27% | 12,205 | 9,484 | $757K |
| 99199 | Unlisted special service, procedure or report | 13% | 62,865 | 36,718 | $363K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 12% | 3,599 | 2,825 | $328K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.7% | 2,809 | 2,526 | $274K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.8% | 1,772 | 1,552 | $163K |
| 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 | 5.7% | 1,774 | 1,536 | $159K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 4.7% | 1,082 | 883 | $133K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 4.1% | 5,999 | 5,217 | $114K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 4.0% | 3,305 | 2,939 | $114K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.8% | 1,082 | 906 | $107K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 2.0% | 2,079 | 1,683 | $55K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.9% | 6,056 | 5,378 | $53K |
51 more codes
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 1.2% | 284 | $33K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.1% | 497 | $30K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 896 | $22K |
| 90474 | <1% | 890 | $18K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 438 | $15K |
| 96127 | <1% | 2,960 | $13K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 307 | $10K |
| 99381 | <1% | 83 | $8K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 244 | $6K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 82 | $5K |
| 99460 | <1% | 83 | $5K | |
| 96161 | <1% | 1,042 | $3K | |
| 92551 | <1% | 2,037 | $3K | |
| 90670 | <1% | 1,750 | $3K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 204 | $3K |
| 96160 | <1% | 590 | $2K | |
| 87807 | <1% | 163 | $2K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 15 | $1K |
| 99173 | <1% | 2,553 | $1K | |
| 90697 | <1% | 583 | $1K | |
| 99070 | <1% | 218 | $1K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 18 | $941.61 |
| 90680 | <1% | 1,467 | $926.19 | |
| 81002 | <1% | 532 | $787.32 | |
| 90734 | <1% | 199 | $657.98 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 56 | $539.54 |
| 90688 | <1% | 924 | $536.72 | |
| 84203 | <1% | 282 | $485.02 | |
| 90671 | <1% | 494 | $456.90 | |
| 90461 | <1% | 358 | $410.22 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 12 | $367.68 |
| 90473 | <1% | 19 | $327.20 | |
| 94664 | <1% | 33 | $324.09 | |
| 94760 | <1% | 2,436 | $313.47 | |
| 85018 | <1% | 273 | $311.19 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 20 | $290.19 |
| 87650 | <1% | 24 | $222.66 | |
| 90651 | <1% | 103 | $220.00 | |
| 90620 | <1% | 47 | $200.00 | |
| 97802 | <1% | 14 | $166.39 | |
| 90686 | <1% | 736 | $115.02 | |
| 99401 | <1% | 14 | $76.60 | |
| 90633 | <1% | 866 | $32.22 | |
| 90685 | 0% | 214 | $0.00 | |
| 90687 | 0% | 171 | $0.00 | |
| 90710 | 0% | 517 | $0.00 | |
| 90672 | 0% | 24 | $0.00 | |
| 90698 | 0% | 1,267 | $0.00 | |
| 90744 | 0% | 488 | $0.00 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 0% | 30 | $0.00 |
| 90696 | 0% | 61 | $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 officialHODGES, ANA (OWNER/PRACTITIONER)
| Provider | Location | Paid |
|---|---|---|
| Pediatric After Hours Care of Fayetteville | Fayetteville, NC | $894K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.