NP / PA
South Mountain Community Health LLC
South Mountain Community Health LLC was paid $883K by Medicaid between Jan 2020 and Dec 2024, across 27 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 63% of everything it billed.
33Billing provider infoSOUTH MOUNTAIN COMMUNITY HEALTH LLC
BOONSBORO, MD 21713
BOONSBORO, MD 21713
33aNPI1932388493assigned 10/31/2007
33bProvider typeFamily Nurse Practitioner
28Total paid$883K
24GClaims12,286
24DCodes billed27
24AFirst – last monthJan 2020 – Dec 2024
Compared with peers
Next to other Family Nurse Practitioner providers in Maryland
Rank by total paid#6 of 195
Median peer was paid$25K
This provider vs. median36×
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 | |
|---|---|---|---|
| 2020 | 2,478 | $135K | |
| 2021 | 2,035 | $151K | |
| 2022 | 2,514 | $213K | |
| 2023 | 3,479 | $236K | |
| 2024incomplete | 1,780 | $148K |
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 | 63% | 7,032 | 5,865 | $560K |
| 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 | 24% | 1,760 | 1,573 | $209K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.3% | 722 | 593 | $29K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.7% | 205 | 201 | $24K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.4% | 100 | 99 | $12K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.3% | 89 | 73 | $11K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 74 | 70 | $9K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 60 | 59 | $7K |
| 90686 | <1% | 378 | 362 | $6K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 225 | 157 | $3K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 187 | 169 | $2K |
| 99401 | <1% | 88 | 75 | $2K |
15 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 13 | $1K |
| 96127 | <1% | 310 | $1K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 64 | $1K |
| 99173 | <1% | 461 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 123 | $829.48 |
| 90651 | <1% | 15 | $634.76 | |
| 90734 | <1% | 15 | $302.64 | |
| 99050 | <1% | 23 | $234.08 | |
| 86580 | <1% | 31 | $226.24 | |
| 81002 | <1% | 72 | $180.05 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 67 | $78.19 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 50 | $68.61 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 78 | $3.00 |
| 90461 | 0% | 23 | $0.00 | |
| S9470 | Nutritional counseling, dietitian visit | 0% | 21 | $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 officialELIZALDE, TRACEY (OWNER)