Managed care
Cherokee Pediatric Associates
Cherokee Pediatric Associates was paid $1.47M by Medicaid between Jan 2018 and Dec 2024, across 33 billing codes. Its largest line is 87426, Infectious agent antigen detection, SARS-CoV-2 (COVID-19) — 52% of everything it billed.
33Billing provider infoCHEROKEE PEDIATRIC ASSOCIATES
BLACKSBURG, SC 29702
BLACKSBURG, SC 29702
33aNPI1811960248assigned 02/08/2006
33bProvider typePreferred Provider Organization
28Total paid$1.47M
24GClaims42,947
24DCodes billed33
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Preferred Provider Organization providers in South Carolina
Rank by total paid#2 of 7
Median peer was paid$452K
This provider vs. median3.3×
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 | 7,044 | $159K | |
| 2019 | 2,234 | $24K | |
| 2020 | 4,318 | $149K | |
| 2021 | 9,217 | $411K | |
| 2022 | 9,816 | $416K | |
| 2023 | 6,796 | $227K | |
| 2024incomplete | 3,522 | $87K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 52% | 15,551 | 13,907 | $771K |
| 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% | 6,606 | 5,716 | $398K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 6.0% | 6,647 | 6,364 | $89K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 3.5% | 3,838 | 3,729 | $51K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.4% | 959 | 914 | $36K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.9% | 315 | 314 | $28K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.5% | 717 | 710 | $21K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.1% | 167 | 167 | $16K |
| 81025 | <1% | 1,811 | 1,700 | $12K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 141 | 141 | $9K |
| 81002 | <1% | 2,931 | 2,746 | $8K | |
| 92552 | <1% | 379 | 376 | $7K |
21 more codes
| 87807 | <1% | 594 | $7K | |
| 90461 | <1% | 223 | $5K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 46 | $5K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 615 | $4K |
| 96127 | <1% | 405 | $3K | |
| 99381 | <1% | 20 | $2K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 24 | $2K |
| 99441 | <1% | 28 | $421.43 | |
| 85018 | <1% | 116 | $307.85 | |
| 99051 | <1% | 19 | $216.00 | |
| 82962 | <1% | 69 | $181.35 | |
| 96161 | <1% | 12 | $97.68 | |
| 86308 | <1% | 16 | $94.70 | |
| 90633 | 0% | 115 | $0.00 | |
| 90710 | 0% | 77 | $0.00 | |
| 90670 | 0% | 138 | $0.00 | |
| 90700 | 0% | 12 | $0.00 | |
| 90723 | 0% | 104 | $0.00 | |
| 90647 | 0% | 132 | $0.00 | |
| 90680 | 0% | 95 | $0.00 | |
| 90696 | 0% | 25 | $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 officialCARLING, DAREN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Cherokee Pediatric Associates, LLC | Gaffney, SC | $5.17M |
| Cherokee Pediatric Associates, LLC | Blacksburg, SC | $1.57M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.