Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Carolina only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Carolina (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Manuel De Pina (NPI 1023041118)

Field	Value
Entity Type	Individual
Organization	Manuel De Pina
Address	1025 Verdae Blvd
City	Greenville
State	SC
ZIP	29607
Taxonomy	Family Medicine Physician
NPI Enumerated	July 9, 2006

Payer Source	Total Paid
Medicare	$2.4M
Medicaid	$0

Key Findings

This provider’s Medicare business is material at $2.4M in lifetime Medicare revenue while Medicaid is absent — “none below” / no Medicaid billing on file — meaning the practice is effectively operating as a single-payer (Medicare) billing entity in the available data. The absence of any Medicaid revenue makes analysis of dual-payer mix moot and concentrates payer exposure on Medicare reimbursement and utilization patterns.

Revenue concentration in Medicare is high: the precomputed top three codes account for 41.1% of the provider’s total Medicare revenue. Those top contributors are J3245 ($396K, 16.8%), J0517 ($320.8K, 13.6%), and J2357 ($253.6K, 10.7%), so a plurality of Medicare dollars comes from a small set of high-value biologic injection codes.

Code mix and procedure descriptions indicate the practice operates a substantial in-office biologics/infusion service despite a Family Medicine Physician taxonomy. The top codes are J3245 (tildrakizumab), J0517 (benralizumab), and J2357 (omalizumab), which are specialty injectable biologics typically used for psoriasis and severe allergic/asthma indications, implying the office supports on-site administration of complex biologic therapies.

Administration and infusion CPTs further support a throughput-oriented infusion practice: 96365 has 431 claims and $19.8K revenue (ranks at the 94th percentile), 96366 has 420 claims and $6.3K revenue (93rd percentile), and 96372 has 433 claims and $4.8K revenue (96th percentile, described as notably above typical national volume). These high-percentile administration codes indicate above-typical procedural volume for delivering injections and infusions relative to national peers.

The provider also bills a broad mix of IV and specialty drug codes beyond the top three biologics, including J1568 ($177.5K, 7.5%), J3380 ($177.6K, 7.5%), J0256 ($212.1K, 9.0%) and several other immune globulin codes (J1561 $139.2K; J1569 $132.7K). Many of these codes show percentile ranks in the mid-to-high range (for example J1568 at the 76th percentile and J3380 at the 66th percentile), reflecting a diversified portfolio of infused specialty therapies rather than a single drug focus.

Competitive standing varies by product: the provider shows an above-typical national footprint for several leading asthma/allergy biologics (J0517 ranks #32 of 200, 84th percentile; J2357 ranks #117 of 581, 80th percentile), while J3245 is a more typical volume for peers (rank #116 of 225, 46th percentile). In short, the practice is a modest-to-strong national participant for certain biologics but not uniformly dominant across all top drug codes.

The provider has a long billing tenure: NPI enumerated 2006-07-09 (~20 years ago), indicating an established practice history that likely supported the build-out of infusion/biologics services over time. Combined with the concentrated revenue profile (top 3 = 41.1%), this tenure suggests established operational capacity to deliver high-cost injectable therapies but also a business model where shifts in utilization or reimbursement for those few drugs could meaningfully affect total Medicare revenue.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3245	Injection, tildrakizumab, 1 mg	3,600	$110	$396K
J0517	Injection, benralizumab, 1 mg	2,430	$130	$320.8K
J2357	Injection, omalizumab, 5 mg	8,750	$30	$253.6K
J0256	Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg	53,030	$1	$212.1K
J3380	Injection, vedolizumab, intravenous, 1 mg	11,100	$20	$177.6K
J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	5,220	$30	$177.5K
J1561	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	3,570	$40	$139.2K
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	3,690	$40	$132.7K
J2182	Injection, mepolizumab, 1 mg	6,100	$20	$128.1K
J2356	Injection, tezepelumab-ekko, 1 mg	7,140	$10	$100K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Manuel De Pina — 1 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3245	9	20	3,800	$110	$435.3K
J3380	10	20	11,400	$20	$231K
J2357	8	30	4,360	$30	$183.8K
J0517	2	20	1,100	$130	$180.6K
J1569	11	20	3,860	$40	$161.4K
J1568	3	10	5,220	$30	$155.1K
J2182	6	10	5,050	$20	$146.9K
J1561	5	10	3,890	$40	$146.6K
J0256	2	10	33,660	$1	$141.1K
J2356	4	10	7,140	$10	$109.9K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Manuel De Pina, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health University Medical Group	SC	Family Medicine Physician	$0	$171.7M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$86.9M
Prisma Health Medical Group-midlands	SC	Multi-Specialty Clinic/Center	$0	$77.6M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$25M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$22M
Prisma Health-upstate	SC	Developmental Disabilities Clinic/Center	$0	$19.7M
Prisma Health University Medical Group	SC	Developmental - Behavioral Pediatrics Physician	$0	$16M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$15.6M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$13.1M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$10.9M

Nearby Providers

Other providers in the same ZIP code as Manuel De Pina, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greenville County Disabilities And Special Needs Board	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$51.7M
Heart Of The Carolinas Medical Supply, LLC	SC	Nursing Care Agency	$0	$36.4M
Caris Healthcare LLC	SC	Community Based Hospice Care Agency	$0	$36.3M
Greenville County Commission On Alcohol And Drug Abuse	SC	Substance Use Disorder Rehabilitation Clinic/Center	$0	$12.7M
St. Francis Hospital Inc	SC	General Acute Care Hospital	$0	$9M
Tribe513, P.A.	SC	Pediatric Adolescent Medicine Physician	$0	$8.6M
Luxor Scientific, LLC	SC	Clinical Medical Laboratory	$2.2M	$5.6M
Pleasantburg Drive Dental Health Center, P.C.	SC	General Practice Dentistry	$0	$6.5M
Inspirium Ihc Upstate, LLC	SC	Home Health Agency	$0	$6.4M
Bon Secours Ambulatory Services - St. Francis, LLC	SC	Urgent Care Clinic/Center	$0	$6.4M

Manuel De Pina — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References