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SOUTH CAROLINA PEDIATRICS ALLIANCE, LLC

Pediatrics, Adolescent Medicine·COLUMBIA, SC·NPI: 1184016941Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$63.4M

$63,422,297

Total Claims

1.5M

Beneficiaries

1.4M

1.1 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2018
$7.1M
-2%
2019
$6.9M
+7%
2020
$7.5M
+39%
2021
$10.4M
+6%
2022
$11.1M
+3%
2023
$11.4M
-21%
2024
$9.0M

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 26% of total spending.

99213Top 25%

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

$16.3M

246K claims · 25.7%

Your Cost: $66.24/claim|Median: $37.81
1.8× median
99214Top 25%

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

$13.4M

140K claims · 21.1%

Your Cost: $95.76/claim|Median: $53.41
1.8× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$5.8M

60K claims · 9.2%

Your Cost: $98.28/claim|Median: $75.18
1.3× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$5.1M

55K claims · 8.0%

Your Cost: $91.52/claim|Median: $69.35
1.3× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$5.0M

162K claims · 7.9%

Your Cost: $30.98/claim|Median: $17.85
1.7× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$3.5M

36K claims · 5.5%

Your Cost: $97.41/claim|Median: $74.82
1.3× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$1.7M

15K claims · 2.6%

Your Cost: $107.46/claim|Median: $80.15
1.3× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$1.5M

32K claims · 2.4%

Your Cost: $48.54/claim|Median: $39.70
1.2× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$1.4M

19K claims · 2.3%

Your Cost: $77.55/claim|Median: $65.64
1.2× median
G9153Normal range

$1.3M

26K claims · 2.1%

Your Cost: $50.94/claim|Median: $43.70
1.2× median
90461Normal range

Immunization admin, additional vaccine, counseling

$1.2M

71K claims · 1.9%

Your Cost: $17.00/claim|Median: $6.93
2.5× median
87426Top 5%

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

$756K

15K claims · 1.2%

Your Cost: $49.55/claim|Median: $30.04
1.6× median
99188Normal range

$614K

40K claims · 1.0%

Your Cost: $15.23/claim|Median: $12.80
1.2× median
96110Normal range

Developmental screening, per standardized instrument

$547K

74K claims · 0.9%

Your Cost: $7.42/claim|Median: $9.10
0.8× median
96127Top 25%

Brief emotional/behavioral assessment, per standardized instrument

$513K

75K claims · 0.8%

Your Cost: $6.80/claim|Median: $3.67
1.9× median
87804Normal range

Influenza virus detection, rapid test

$439K

32K claims · 0.7%

Your Cost: $13.54/claim|Median: $12.59
1.1× median
99460Top 25%

Initial hospital or birthing center care, newborn, per day

$434K

5,179 claims · 0.7%

Your Cost: $83.77/claim|Median: $62.48
1.3× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$433K

32K claims · 0.7%

Your Cost: $13.43/claim|Median: $11.48
1.2× median
99212Top 25%

Office/outpatient visit, low complexity

$400K

9,964 claims · 0.6%

Your Cost: $40.14/claim|Median: $25.06
1.6× median
87428Top 25%

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

$348K

5,792 claims · 0.5%

Your Cost: $60.16/claim|Median: $39.63
1.5× median
99238Top 10%

Hospital discharge day management, 30 minutes or less

$347K

5,306 claims · 0.5%

Your Cost: $65.39/claim|Median: $37.22
1.8× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$345K

12K claims · 0.5%

Your Cost: $27.64/claim|Median: $28.46
1.0× median
96161Top 25%

$335K

43K claims · 0.5%

Your Cost: $7.84/claim|Median: $2.49
3.1× median
G0447Normal range

$269K

23K claims · 0.4%

Your Cost: $11.88/claim|Median: $5.19
2.3× median
90847Top 25%

Family psychotherapy with patient, 50 min

$154K

1,525 claims · 0.2%

Your Cost: $101.03/claim|Median: $77.33
1.3× median
85018Normal range

$153K

67K claims · 0.2%

Your Cost: $2.27/claim|Median: $1.71
1.3× median
87634Normal range

$111K

1,938 claims · 0.2%

Your Cost: $57.43/claim|Median: $48.78
1.2× median
80061Normal range

Lipid panel

$97K

8,901 claims · 0.2%

Your Cost: $10.92/claim|Median: $8.41
1.3× median
99401Top 10%

$91K

2,884 claims · 0.1%

Your Cost: $31.72/claim|Median: $16.53
1.9× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$77K

10K claims · 0.1%

Your Cost: $7.35/claim|Median: $4.71
1.6× median
99051Normal range

$75K

6,565 claims · 0.1%

Your Cost: $11.43/claim|Median: $7.89
1.4× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$73K

1,292 claims · 0.1%

Your Cost: $56.12/claim|Median: $40.11
1.4× median
U0002Top 25%

COVID-19 lab test, non-CDC, nucleic acid

$63K

1,251 claims · 0.1%

Your Cost: $50.71/claim|Median: $34.62
1.5× median
99177Normal range

$60K

14K claims · 0.1%

Your Cost: $4.18/claim|Median: $3.74
1.1× median
99462Top 25%

$56K

1,625 claims · 0.1%

Your Cost: $34.64/claim|Median: $27.49
1.3× median
99211Top 25%

Office/outpatient visit, minimal complexity

$55K

2,764 claims · 0.1%

Your Cost: $19.91/claim|Median: $12.93
1.5× median
83655Top 25%

$34K

2,746 claims · 0.1%

Your Cost: $12.32/claim|Median: $10.49
1.2× median
87811Top 25%

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$31K

771 claims · 0.0%

Your Cost: $40.57/claim|Median: $30.53
1.3× median
0071ANormal range

$29K

747 claims · 0.0%

Your Cost: $38.80/claim|Median: $38.71
1.0× median
81003Top 25%

Urinalysis, automated without microscopy

$18K

7,540 claims · 0.0%

Your Cost: $2.37/claim|Median: $1.48
1.6× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$15K

386 claims · 0.0%

Your Cost: $38.45/claim|Median: $33.72
1.1× median
87807Normal range

$14K

1,311 claims · 0.0%

Your Cost: $10.94/claim|Median: $10.06
1.1× median
0072ANormal range

$13K

330 claims · 0.0%

Your Cost: $40.00/claim|Median: $39.57
1.0× median
90480Normal range

$13K

410 claims · 0.0%

Your Cost: $30.68/claim|Median: $25.29
1.2× median
96160Top 25%

Patient-focused health risk assessment

$12K

1,651 claims · 0.0%

Your Cost: $7.46/claim|Median: $2.10
3.6× median
94010Normal range

$12K

498 claims · 0.0%

Your Cost: $24.73/claim|Median: $18.11
1.4× median
86769Top 25%

Antibody, SARS-CoV-2 (COVID-19)

$11K

267 claims · 0.0%

Your Cost: $41.21/claim|Median: $26.94
1.5× median
99203Top 25%

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

$9K

106 claims · 0.0%

Your Cost: $86.85/claim|Median: $57.85
1.5× median
82247Top 25%

$9K

1,638 claims · 0.0%

Your Cost: $5.35/claim|Median: $2.74
2.0× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$9K

220 claims · 0.0%

Your Cost: $39.68/claim|Median: $36.70
1.1× median

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