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.

South Carolina Ent Allergy & Sleep Medicine PA (NPI 1134153083)

South Carolina Ent Allergy & Sleep Medicine PA is a otolaryngology physician provider located in Lugoff, South Carolina. This profile covers 0 Medicare and 36 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	South Carolina Ent Allergy & Sleep Medicine PA
Address	15 Exchange Dr
City	Lugoff
State	SC
ZIP	29078
Taxonomy	Otolaryngology Physician
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$16.7M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	18,890	$230	$4.3M
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…	50,100	$70	$3.7M
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	9,110	$150	$1.4M
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	11,150	$120	$1.3M
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	121,940	$10	$975.5K
99204	The provider sees a new 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 provider…	8,200	$100	$844.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,970	$410	$808K
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…	12,840	$60	$770.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2,980	$180	$547.4K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	710	$690	$494.1K

Showing 1–10 of 36

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Carolina Distribution

South Carolina Ent Allergy & Sleep Medicine PA — 11 of 25 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. South Carolina median

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	7	20	380	$520	$421.9K
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.	1	40	120	$220	$367.6K
95027	The provider introduces sequential and incremental airborne allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a…	1	10	1,960	$150	$299K
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…	193	2,770	210	$60	$254.5K
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…	18	2,480	350	$80	$246K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	6	30	860	$130	$203.7K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	6	40	120	$330	$201.6K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	4	110	70	$150	$157.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	14	50	480	$160	$147.9K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	1	30	170	$120	$120.1K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Orville Dyce	SC	Otolaryngology Physician	$311.1K	$52.5K
Brian Boone	SC	Otolaryngology Physician	$282K	$14.5K
Robert Puchalski	SC	Sleep Medicine (Otolaryngology) Physician	$254.7K	$20.6K
Janaki Emani	SC	Otolaryngology Physician	$196.8K	$17.1K
David Vidrine	GA	Otolaryngology Physician	$163K	$41.2K
Joseph Sciarrino	GA	Otolaryngology Physician	$185.3K	$10.6K
Ira Uretzky	SC	Otolaryngology Physician	$195.5K	$0
Liuba Soldatova	SC	Otolaryngology Physician	$167.7K	$0
Andrew Battiata	SC	Otolaryngology Physician	$146.5K	$0
Natalie Sciarrino	GA	Otolaryngology Physician	$107.4K	$1000

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sandhills Medical Foundation, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$3.2M
Lifeline Ambulance	SC	Ambulance	$1.1M	$3.5K
James Kearse	SC	Family Medicine Physician	$327.2K	$870
Anne Blake	SC	Family Nurse Practitioner	$308.9K	$0
Jennifer Carter	SC	Medical Physician Assistant	$165.1K	$0
Min Kang	SC	Family Medicine Physician	$143.2K	$1.6K
Julie Taylor	SC	Internal Medicine Physician	$58.3K	$0
Kelly Long	SC	Audiologist	$9K	$0

South Carolina Ent Allergy & Sleep Medicine PA — Billing Profile & Reimbursement Data

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South Carolina Ent Allergy & Sleep Medicine PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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