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NPI 1164519070 · Jacksonville, NC · Family Medicine Physician
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Jacksonville Children's And Multispecialty Clinic, PA is a family medicine physician provider located in Jacksonville, North Carolina. This profile covers 0 Medicare and 124 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Jacksonville Children's And Multispecialty Clinic, PA |
| Address | 118 Memorial Dr |
| City | Jacksonville |
| State | NC |
| ZIP | 28546 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | October 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $44.6M |
| Medicare | $0 |
This provider is effectively single‑payer in the available data: there is no Medicare billing on file while lifetime Medicaid revenue is $44.6M, indicating that Medicaid drives the practice’s entire documented public-payer footprint. Analysts should treat the profile as Medicaid-centric when assessing network participation or utilization patterns.
Revenue is highly concentrated in a small set of E/M and unspecified services: the top three Medicaid codes (99213, 99199, 99214) together account for 66.5% of the provider’s total Medicaid revenue. Individually those codes generated $12.6M (99213, 28.9%), $8.8M (99199, 20.2%), and $7.6M (99214, 17.4%), making them the primary levers of financial performance.
The operational mix implied by the top codes points to high-volume primary and preventive care with substantial use of an open-ended catch-all procedure. Large counts for 99213 (225K claims) and 99214 (101.5K claims) indicate heavy throughput of established office visits, while the 99199 volume (1.8M claims) suggests frequent reporting of services that lack specific CPT codes or aggregated items billed under an other‑services code. Together this pattern is consistent with a high-volume family/pediatric practice that relies on routine visits plus many ancillary or otherwise uncoded interventions.
Competitive standing within the state is dominant for multiple visit and preventive codes: 99213 ranks #8 of 4130 providers in-state (100th percentile; extreme outlier), 99199 ranks #8 of 2853 (100th percentile; extreme outlier), and 99214 ranks #13 of 4404 (100th percentile; extreme outlier). These ranks indicate this clinic is a major statewide outlier in volume and revenue for core ambulatory E/M and uncoded medicine services.
Preventive and pediatric well-visit activity is also a clear service line: 99391 ($2.9M, 6.6%), 99392 ($2.4M, 5.4%), 99393 ($1.5M, 3.5%), and 99394 ($760.9K, 1.7%) appear among the top codes, with 99391 and 99392 ranking in the 99th percentile statewide (extreme outlier). High volumes for these well‑child and preventive medicine codes, together with substantial vaccine administration codes 90472 and 90471, reinforce that routine pediatric preventive care and immunizations are a significant operational focus.
The provider shows unusually high utilization of screening, testing, and brief behavioral assessments: 96110 (52.7K claims, $474.7K) ranks #4 of 651 providers in-state (100th percentile; extreme outlier), and 96127 (52.5K claims, $210.1K) ranks #3 of 897 providers (100th percentile; extreme outlier). Similarly, point-of-care testing codes such as 87880 (32.2K claims) and 87804 (17.1K claims) are far above typical state volumes, indicating on-site rapid diagnostics are a routine part of encounters.
The practice additionally bills a notable volume of newborn and pediatric procedural codes (99460, 99462, 99393) and dental/fluoride codes (D0145, D1206), suggesting a broad scope of family medicine services that include newborn evaluation and some oral preventive procedures under Medicaid. Multiple of these codes rank in the top percentiles statewide (for example, D0145 ranks #10 of 460 providers, 98th percentile), signaling above-typical service breadth for a Family Medicine taxonomy in the state Medicaid population.
The provider has long tenure in the NPI registry, enumerated on 2006-10-10 (~20 years ago), which supports interpretation of these volumes as sustained operations rather than a short-term spike. Given the combination of long tenure, concentrated revenue in a few codes (66.5% from the top three), and multiple state-level extreme outlier ranks, this clinic represents an established, high-volume Medicaid primary-care and preventive services hub within the state.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
124 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 225,040 | $60 | $12.6M |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 1,760,790 | $10 | $8.8M |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 101,470 | $80 | $7.6M |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 34,520 | $80 | $2.9M |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 27,730 | $90 | $2.4M |
| 90472 | This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection. | 42,470 | $40 | $1.6M |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 17,750 | $90 | $1.5M |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 70,480 | $20 | $1.3M |
| 99394 | The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17. | 8,360 | $90 | $760.9K |
| 96110 | The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate… | 52,740 | $10 | $474.7K |
Showing 1–10 of 124
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
124 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 8 | 2,850 | 10,910 | $10 | $330.3K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 13 | 4,400 | 960 | $60 | $271.3K |
| 95165 | In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens. | 44 | 90 | 320 | $160 | $262.5K |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 4 | 520 | 1,080 | $80 | $262.1K |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 5 | 550 | 970 | $90 | $258.9K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 8 | 4,130 | 670 | $50 | $219.9K |
| 95004 | The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient. | 20 | 100 | 200 | $150 | $212.6K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 7 | 590 | 490 | $90 | $179.8K |
| 90460 | In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age. | 323 | 380 | 460 | $40 | $173.1K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 502 | 510 | 480 | $40 | $166.3K |
Showing 1–10 of 124
Other providers in the same ZIP code as Jacksonville Children's And Multispecialty Clinic, PA, ranked by combined Medicare and Medicaid revenue.
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