Agency
County of Macon
County of Macon was paid $2.15M by Medicaid between Jan 2018 and Dec 2024, across 40 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 32% of everything it billed.
33Billing provider infoCOUNTY OF MACON
FRANKLIN, NC 28734
FRANKLIN, NC 28734
33aNPI1720161334assigned 10/24/2006
33bProvider typeCase Management Agency
28Total paid$2.15M
24GClaims182,496
24DCodes billed40
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Case Management Agency providers in North Carolina
Rank by total paid#96 of 195
Median peer was paid$2.05M
This provider vs. median1.0×
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 | 10,852 | $328K | |
| 2019 | 8,695 | $287K | |
| 2020 | 4,723 | $86K | |
| 2021 | 20,616 | $309K | |
| 2022 | 39,580 | $364K | |
| 2023 | 44,947 | $387K | |
| 2024incomplete | 53,083 | $388K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 32% | 134,113 | 112,835 | $684K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 20% | 5,613 | 2,248 | $419K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.9% | 2,104 | 1,299 | $212K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.0% | 5,758 | 5,225 | $150K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.7% | 4,449 | 4,002 | $123K |
| D1206 | Topical application of fluoride varnish | 5.1% | 6,764 | 6,121 | $109K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.1% | 5,529 | 2,545 | $68K |
| D1351 | Sealant - per tooth | 2.6% | 1,894 | 407 | $55K |
| D1110 | Prophylaxis - adult | 2.6% | 1,474 | 1,323 | $55K |
| D0220 | Intraoral - periapical first radiographic image | 2.3% | 3,206 | 2,854 | $49K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.2% | 709 | 509 | $48K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.2% | 1,025 | 958 | $47K |
28 more codes
| D0272 | Bitewings - two radiographic images | 1.5% | 1,675 | $32K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1.1% | 1,201 | $23K |
| D0274 | Bitewings - four radiographic images | 1.1% | 680 | $23K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,567 | $16K |
| D0140 | Limited oral evaluation - problem focused | <1% | 386 | $13K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 58 | $8K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 244 | $5K |
| 36415 | Collection of venous blood by venipuncture | <1% | 867 | $2K |
| 81002 | <1% | 552 | $2K | |
| D0330 | Panoramic radiographic image | <1% | 29 | $2K |
| 90686 | <1% | 814 | $1K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 16 | $1K |
| 90688 | <1% | 144 | $728.71 | |
| 81025 | <1% | 96 | $691.44 | |
| 90734 | <1% | 32 | $375.00 | |
| 0064A | <1% | 13 | $257.00 | |
| 90715 | <1% | 22 | $160.44 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 14 | $135.74 |
| 86592 | <1% | 89 | $13.39 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 58 | $9.88 |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 0% | 70 | $0.00 |
| 90685 | 0% | 30 | $0.00 | |
| 90649 | 0% | 15 | $0.00 | |
| 91300 | 0% | 25 | $0.00 | |
| 87390 | 0% | 101 | $0.00 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 0% | 977 | $0.00 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 0% | 70 | $0.00 |
| 91306 | 0% | 13 | $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 officialSETZER, MELISSA (FINANCE OFFICER)