Is ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC flagged for Medicaid fraud?

ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC (NPI: 1861430555) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC bill Medicaid?

ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Emergency Medicine provider. Located in MYRTLE BEACH, SC.

What is NPI 1861430555?

NPI 1861430555 is the National Provider Identifier for ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC. They are a Emergency Medicine provider based in MYRTLE BEACH, SC. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC

Emergency Medicine·MYRTLE BEACH, SC·NPI: 1861430555Share

Compared to Emergency Medicine Peers

Total spending distribution among 11 providers in this specialty

P25MedianP75P90

This provider's total spending of $81.3M is at the 50th percentile among 11 Emergency Medicine providers.

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

Total Paid

$81.3M

$81,337,829

Total Claims

1.2M

Beneficiaries

1.1M

1.1 claims/patient

Avg Cost/Claim

$70

Monthly Spending Trend

Yearly Spending

2018

$11.1M

-3%

2019

$10.7M

-5%

2020

$10.2M

+19%

2021

$12.1M

+14%

2022

$13.8M

-1%

2023

$13.7M

-30%

2024

$9.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 22 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 45% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

99284Emergency dept visit, high complexitySee all providers →

$36.6M

453K claims

$80.68

$69.51

1.2×

Normal range

99284Normal range

Emergency dept visit, high complexity

$36.6M

453K claims · 45.0%

Your Cost: $80.68/claim|Median: $69.51

1.2× median

99285Emergency dept visit, high/urgent complexitySee all providers →

$28.0M

278K claims

$100.88

$85.65

1.2×

Normal range

99285Normal range

Emergency dept visit, high/urgent complexity

$28.0M

278K claims · 34.4%

Your Cost: $100.88/claim|Median: $85.65

1.2× median

99283Emergency dept visit, moderate complexitySee all providers →

$16.4M

361K claims

$45.57

$42.48

1.1×

Normal range

99283Normal range

Emergency dept visit, moderate complexity

$16.4M

361K claims · 20.2%

Your Cost: $45.57/claim|Median: $42.48

1.1× median

93010Electrocardiogram, interpretation and report onlySee all providers →

$195K

45K claims

$4.33

$5.60

0.8×

Normal range

93010Normal range

Electrocardiogram, interpretation and report only

$195K

45K claims · 0.2%

Your Cost: $4.33/claim|Median: $5.60

0.8× median

99282Emergency dept visit, low complexitySee all providers →

$26K

834 claims

$30.94

$37.72

0.8×

Normal range

99282Normal range

Emergency dept visit, low complexity

$26K

834 claims · 0.0%

Your Cost: $30.94/claim|Median: $37.72

0.8× median

99291Critical care, first 30-74 minutesSee all providers →

$21K

181 claims

$114.89

$101.24

1.1×

Normal range

99291Normal range

Critical care, first 30-74 minutes

$21K

181 claims · 0.0%

Your Cost: $114.89/claim|Median: $101.24

1.1× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$18K

224 claims

$78.14

$57.85

1.4×

Top 25%

99203Top 25%

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

$18K

224 claims · 0.0%

Your Cost: $78.14/claim|Median: $57.85

1.4× median

99053 See all providers →

$15K

28K claims

$0.54

$0.38

1.4×

Normal range

99053Normal range

$15K

28K claims · 0.0%

Your Cost: $0.54/claim|Median: $0.38

1.4× median

U0002COVID-19 lab test, non-CDC, nucleic acidSee all providers →

$13K

241 claims

$52.15

$34.62

1.5×

Top 10%

U0002Top 10%

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

$13K

241 claims · 0.0%

Your Cost: $52.15/claim|Median: $34.62

1.5× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$12K

338 claims

$35.94

$37.81

1.0×

Normal range

99213Normal range

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

$12K

338 claims · 0.0%

Your Cost: $35.94/claim|Median: $37.81

1.0× median

87426SARS-CoV-2 COVID-19 antigen detection, immunoassaySee all providers →

$8K

233 claims

$36.40

$30.04

1.2×

Top 25%

87426Top 25%

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

$8K

233 claims · 0.0%

Your Cost: $36.40/claim|Median: $30.04

1.2× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$7K

107 claims

$65.07

$53.41

1.2×

Normal range

99214Normal range

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

$7K

107 claims · 0.0%

Your Cost: $65.07/claim|Median: $53.41

1.2× median

99051 See all providers →

$2K

109 claims

$19.32

$7.89

2.4×

Top 25%

99051Top 25%

$2K

109 claims · 0.0%

Your Cost: $19.32/claim|Median: $7.89

2.4× median

99202Office/outpatient visit, new patient, low complexitySee all providers →

$830

16 claims

$51.88

$40.11

1.3×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$830

16 claims · 0.0%

Your Cost: $51.88/claim|Median: $40.11

1.3× median

87635COVID-19 SARS-CoV-2 amplified probe detectionSee all providers →

$631

12 claims

$52.60

$39.70

1.3×

Top 10%

87635Top 10%

COVID-19 SARS-CoV-2 amplified probe detection

$631

12 claims · 0.0%

Your Cost: $52.60/claim|Median: $39.70

1.3× median

99406 See all providers →

$435

53 claims

$8.20

$6.53

1.3×

Normal range

99406Normal range

$435

53 claims · 0.0%

Your Cost: $8.20/claim|Median: $6.53

1.3× median

S9083Global fee, urgent care centersSee all providers →

$400

32 claims

$12.50

$103.99

0.1×

Normal range

S9083Normal range

Global fee, urgent care centers

$400

32 claims · 0.0%

Your Cost: $12.50/claim|Median: $103.99

0.1× median

87804Influenza virus detection, rapid testSee all providers →

$333

29 claims

$11.49

$12.59

0.9×

Normal range

87804Normal range

Influenza virus detection, rapid test

$333

29 claims · 0.0%

Your Cost: $11.49/claim|Median: $12.59

0.9× median

36410 See all providers →

$248

16 claims

$15.53

$5.72

2.7×

Top 10%

36410Top 10%

$248

16 claims · 0.0%

Your Cost: $15.53/claim|Median: $5.72

2.7× median

99072 See all providers →

15 claims

$0.00

$0.54

—

Normal range

99072Normal range

15 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.54

G8484 See all providers →

84 claims

$0.00

$0.06

—

Normal range

G8484Normal range

84 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.06

G8432 See all providers →

14 claims

$0.00

$0.02

—

Normal range

G8432Normal range

14 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.02

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