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SOUTHERN MEDICAL MANAGEMENT, LLC

Pediatrics·LEXINGTON, SC·NPI: 1114196557Share

Compared to Pediatrics Peers

Total spending distribution among 14 providers in this specialty

P25MedianP75P90

This provider's total spending of $43.9M is at the 25th percentile among 14 Pediatrics providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$43.9M

$43,860,426

Total Claims

870K

Beneficiaries

809K

1.1 claims/patient

Avg Cost/Claim

$50

Monthly Spending Trend

Yearly Spending

2018
$3.2M
+11%
2019
$3.5M
+23%
2020
$4.3M
+57%
2021
$6.8M
+26%
2022
$8.6M
+17%
2023
$10.1M
-26%
2024
$7.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 24% of total spending.

99213Top 25%

Office/outpatient visit, est. patient, low-mod complexity

$10.7M

159K claims · 24.4%

Your Cost: $67.55/claim|Median: $37.81
1.8× median
99214Top 25%

Office/outpatient visit, est. patient, mod-high complexity

$9.3M

96K claims · 21.2%

Your Cost: $96.48/claim|Median: $53.41
1.8× median
90460Top 5%

Immunization administration, first vaccine/toxoid, with counseling

$4.3M

79K claims · 9.8%

Your Cost: $54.59/claim|Median: $17.85
3.1× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$3.7M

37K claims · 8.3%

Your Cost: $99.70/claim|Median: $75.18
1.3× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$3.1M

34K claims · 7.1%

Your Cost: $91.98/claim|Median: $69.35
1.3× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$2.6M

26K claims · 6.0%

Your Cost: $100.15/claim|Median: $74.82
1.3× median
90837Top 25%

Psychotherapy, 60 minutes

$2.3M

22K claims · 5.2%

Your Cost: $105.84/claim|Median: $85.66
1.2× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$1.4M

13K claims · 3.2%

Your Cost: $110.38/claim|Median: $80.15
1.4× median
G9153Normal range

$1.2M

24K claims · 2.7%

Your Cost: $49.22/claim|Median: $43.70
1.1× median
87428Top 25%

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$976K

16K claims · 2.2%

Your Cost: $60.47/claim|Median: $39.63
1.5× median
87426Top 5%

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$882K

18K claims · 2.0%

Your Cost: $48.62/claim|Median: $30.04
1.6× median
90461Top 25%

Immunization admin, additional vaccine, counseling

$650K

24K claims · 1.5%

Your Cost: $26.56/claim|Median: $6.93
3.8× median
87804Normal range

Influenza virus detection, rapid test

$463K

35K claims · 1.1%

Your Cost: $13.39/claim|Median: $12.59
1.1× median
96127Top 25%

Brief emotional/behavioral assessment, per standardized instrument

$239K

35K claims · 0.5%

Your Cost: $6.76/claim|Median: $3.67
1.8× median
90791Top 25%

Psychiatric diagnostic evaluation

$217K

1,421 claims · 0.5%

Your Cost: $152.50/claim|Median: $99.21
1.5× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$193K

14K claims · 0.4%

Your Cost: $13.36/claim|Median: $11.48
1.2× median
G2023Top 10%

Specimen collection for COVID-19 testing

$191K

7,759 claims · 0.4%

Your Cost: $24.56/claim|Median: $17.15
1.4× median
99460Top 25%

Initial hospital or birthing center care, newborn, per day

$173K

2,203 claims · 0.4%

Your Cost: $78.63/claim|Median: $62.48
1.3× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$113K

1,841 claims · 0.3%

Your Cost: $61.29/claim|Median: $37.22
1.6× median
87430Normal range

$108K

8,221 claims · 0.2%

Your Cost: $13.18/claim|Median: $9.41
1.4× median
99174Normal range

$102K

19K claims · 0.2%

Your Cost: $5.31/claim|Median: $5.27
1.0× median
99381Top 25%

Preventive visit, new patient, infant (<1 yr)

$97K

925 claims · 0.2%

Your Cost: $105.21/claim|Median: $73.46
1.4× median
83655Normal range

$95K

7,987 claims · 0.2%

Your Cost: $11.90/claim|Median: $10.49
1.1× median
99499Top 10%

Unlisted evaluation and management service

$95K

1,267 claims · 0.2%

Your Cost: $75.00/claim|Median: $30.88
2.4× median
92551Normal range

Screening audiometry, pure tone, air only

$86K

20K claims · 0.2%

Your Cost: $4.37/claim|Median: $6.61
0.7× median
90834Normal range

Psychotherapy, 45 minutes

$74K

1,030 claims · 0.2%

Your Cost: $72.11/claim|Median: $63.65
1.1× median
99051Normal range

$68K

5,859 claims · 0.2%

Your Cost: $11.68/claim|Median: $7.89
1.5× median
99188Normal range

$68K

4,241 claims · 0.2%

Your Cost: $16.12/claim|Median: $12.80
1.3× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$65K

8,619 claims · 0.1%

Your Cost: $7.54/claim|Median: $4.71
1.6× median
0241UNormal range

Proprietary lab analysis, genomic sequencing

$61K

487 claims · 0.1%

Your Cost: $125.70/claim|Median: $91.47
1.4× median
96110Normal range

Developmental screening, per standardized instrument

$49K

6,759 claims · 0.1%

Your Cost: $7.27/claim|Median: $9.10
0.8× median
87807Normal range

$43K

3,805 claims · 0.1%

Your Cost: $11.20/claim|Median: $10.06
1.1× median
96161Top 25%

$39K

5,122 claims · 0.1%

Your Cost: $7.64/claim|Median: $2.49
3.1× median
99203Top 25%

Office/outpatient visit, new patient, low-mod complexity

$37K

432 claims · 0.1%

Your Cost: $85.51/claim|Median: $57.85
1.5× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$29K

217 claims · 0.1%

Your Cost: $131.47/claim|Median: $84.03
1.6× median
81002Top 25%

Urinalysis, non-automated without microscopy

$25K

8,536 claims · 0.1%

Your Cost: $2.91/claim|Median: $2.00
1.5× median
87400Normal range

$11K

982 claims · 0.0%

Your Cost: $11.66/claim|Median: $8.40
1.4× median
90832Normal range

Psychotherapy, 30 minutes

$10K

279 claims · 0.0%

Your Cost: $37.04/claim|Median: $41.28
0.9× median
94640Normal range

Pressurized or nonpressurized inhalation treatment

$6K

495 claims · 0.0%

Your Cost: $12.13/claim|Median: $10.88
1.1× median
85018Normal range

$5K

2,231 claims · 0.0%

Your Cost: $2.25/claim|Median: $1.71
1.3× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$5K

226 claims · 0.0%

Your Cost: $21.45/claim|Median: $38.83
0.6× median
99383Top 25%

Preventive visit, new patient, late childhood (5-11 yr)

$5K

43 claims · 0.0%

Your Cost: $110.11/claim|Median: $81.92
1.3× median
36415Top 25%

Collection of venous blood by venipuncture

$4K

1,515 claims · 0.0%

Your Cost: $2.90/claim|Median: $1.57
1.8× median
82465Normal range

$4K

1,076 claims · 0.0%

Your Cost: $3.67/claim|Median: $3.41
1.1× median
96131Top 25%

Psychological testing evaluation, each additional hour

$3K

12 claims · 0.0%

Your Cost: $273.33/claim|Median: $133.38
2.0× median
90677Normal range

$3K

3,800 claims · 0.0%

Your Cost: $0.76/claim|Median: $12.96
0.1× median
99382Top 25%

Preventive visit, new patient, early childhood (1-4 yr)

$3K

27 claims · 0.0%

Your Cost: $100.29/claim|Median: $79.89
1.3× median
99462Top 25%

$2K

48 claims · 0.0%

Your Cost: $35.12/claim|Median: $27.49
1.3× median
81003Normal range

Urinalysis, automated without microscopy

$2K

845 claims · 0.0%

Your Cost: $1.87/claim|Median: $1.48
1.3× median
99395Top 10%

Preventive medicine, established patient, age 18-39

$1K

12 claims · 0.0%

Your Cost: $116.75/claim|Median: $72.71
1.6× median

Other Top Providers in South Carolina

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Medical University Hospital Authority

General Acute Care Hospital

$241.4M

Spartanburg Medical Center

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$187.8M

Prisma Health University Medical Group

Internal Medicine

$172.2M

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