Physician
Sumter Pediatrics, P.A.
Sumter Pediatrics, P.A. was paid $24.37M by Medicaid between Jan 2018 and Dec 2024, across 66 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 44% of everything it billed.
33Billing provider infoSUMTER PEDIATRICS, P.A.
SUMTER, SC 29150
SUMTER, SC 29150
33aNPI1871593749assigned 07/21/2005
33bProvider typePediatrics Physician
28Total paid$24.37M
24GClaims529,102
24DCodes billed66
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in South Carolina
Rank by total paid#3 of 471
Median peer was paid$18K
This provider vs. median1,381×
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 | 81,726 | $2.93M | |
| 2019 | 66,553 | $2.54M | |
| 2020 | 63,085 | $2.68M | |
| 2021 | 78,687 | $3.70M | |
| 2022 | 82,823 | $4.17M | |
| 2023 | 85,495 | $4.48M | |
| 2024incomplete | 70,733 | $3.87M |
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 | 44% | 149,175 | 128,742 | $10.69M |
| 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 | 12% | 27,078 | 24,846 | $2.83M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 50,407 | 49,369 | $2.50M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 9.0% | 22,267 | 20,699 | $2.20M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.3% | 18,879 | 18,621 | $2.01M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.5% | 9,944 | 9,796 | $1.09M |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.6% | 5,249 | 5,179 | $629K |
| 87428 | 2.1% | 8,076 | 7,833 | $516K | |
| 90461 | 1.8% | 16,947 | 16,593 | $429K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.1% | 8,914 | 8,384 | $263K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 12,398 | 12,029 | $174K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 3,142 | 3,073 | $168K |
54 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 958 | $105K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 12,607 | $102K |
| 85018 | <1% | 33,380 | $81K | |
| 87430 | <1% | 4,246 | $66K | |
| 99051 | <1% | 4,607 | $62K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 903 | $56K |
| 83655 | <1% | 4,332 | $56K | |
| 81002 | <1% | 17,787 | $55K | |
| 92551 | <1% | 21,561 | $50K | |
| 99223 | Prolong inpt eval add15 m | <1% | 262 | $44K |
| 81000 | <1% | 7,668 | $32K | |
| 87807 | <1% | 2,559 | $30K | |
| 96160 | <1% | 3,341 | $29K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 2,273 | $28K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 220 | $14K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,928 | $12K |
| 99177 | <1% | 1,992 | $9K | |
| 99070 | <1% | 1,015 | $7K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 2,638 | $5K |
| G9153 | Mapcp demonstration - physician incentive pool | <1% | 57 | $4K |
| 99050 | <1% | 233 | $3K | |
| 82247 | <1% | 562 | $3K | |
| 96161 | <1% | 725 | $3K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 316 | $3K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 30 | $2K |
| 90686 | <1% | 7,187 | $1K | |
| 99460 | <1% | 14 | $1K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 29 | $1K |
| 90677 | <1% | 2,194 | $684.57 | |
| 94760 | <1% | 2,102 | $615.73 | |
| 90651 | <1% | 1,685 | $595.30 | |
| 90670 | <1% | 11,708 | $570.82 | |
| 90620 | <1% | 110 | $498.95 | |
| 86308 | <1% | 66 | $470.01 | |
| 99462 | <1% | 16 | $453.50 | |
| 90698 | <1% | 10,351 | $353.83 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 34 | $285.38 |
| 90715 | <1% | 411 | $165.69 | |
| 90734 | <1% | 479 | $151.45 | |
| 90744 | <1% | 5,739 | $122.00 | |
| 90633 | <1% | 6,668 | $116.49 | |
| 86580 | <1% | 16 | $112.53 | |
| 90680 | <1% | 9,038 | $95.24 | |
| 90700 | <1% | 4,592 | $37.74 | |
| 90685 | <1% | 837 | $23.29 | |
| 90656 | <1% | 258 | $19.29 | |
| 90710 | 0% | 1,010 | $0.00 | |
| 90707 | 0% | 309 | $0.00 | |
| 99173 | 0% | 112 | $0.00 | |
| 90713 | 0% | 558 | $0.00 | |
| 90648 | 0% | 412 | $0.00 | |
| 36416 | 0% | 2,833 | $0.00 | |
| 90716 | 0% | 308 | $0.00 | |
| 90619 | 0% | 350 | $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 officialKEY, TIMOTHY (TREASURER)