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.

Roper Saint Francis Physicians Network (NPI 1144609173)

Roper Saint Francis Physicians Network is a family medicine physician provider located in Summerville, South Carolina. This profile covers 0 Medicare and 19 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	Roper Saint Francis Physicians Network
Address	1114 N Main St
City	Summerville
State	SC
ZIP	29483
Taxonomy	Family Medicine Physician
NPI Enumerated	May 22, 2015

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

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

19 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…	11,730	$50	$586.5K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	3,300	$120	$382.9K
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…	4,480	$80	$336.1K
99203	The provider sees a new 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 provider…	2,490	$80	$194.5K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	1,680	$50	$84.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	740	$60	$45.3K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	2,510	$10	$27.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	530	$40	$19.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,060	$10	$13.8K
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…	60	$90	$5.4K

Showing 1–10 of 19

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

Roper Saint Francis Physicians Network — 0 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	21	70	600	$130	$307.2K
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…	215	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	241	710	350	$60	$247.2K
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…	345	2,480	350	$80	$246K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	210	410	330	$50	$152.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	49	170	500	$50	$128.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	218	610	190	$50	$98.4K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	203	270	120	$50	$93.2K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	279	380	660	$30	$90K
99203	The provider sees a new 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 provider…	37	520	70	$70	$67.1K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roper Saint Francis Physicians Network	SC	Family Medicine Physician	$0	$2.9M
Roper Saint Francis Physicians Network	SC	Family Medicine Physician	$0	$2.8M
Susan Yonce	SC	Family Nurse Practitioner	$2.3M	$0
Danyel Mcevoy	SC	Anatomic Pathology & Clinical Pathology Physician	$2.3M	$0
Roper Saint Francis Physicians Network	SC	Clinical Medical Laboratory	$40.4K	$1.3M
Kathryn Conner	SC	Medical Physician Assistant	$904.3K	$0
Stephen Ramey	SC	Radiation Oncology Physician	$608K	$0
Jeffrey Rieder	SC	Interventional Cardiology Physician	$554.1K	$0
John Mccrosson	SC	Adult Reconstructive Orthopaedic Surgery Physician	$510.8K	$0
Troy Bunting	SC	Cardiovascular Disease Physician	$461.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dorchester County Disabilities And Special Needs Board	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.7M
Allied Medical Staffing	SC	In Home Supportive Care Agency	$0	$6.7M
Dorchester County Ems	SC	Ambulance	$1.4M	$2.5M
Dorchester School District Two	SC	Local Education Agency (LEA)	$0	$3.5M
Palmetto Kids Dentistry	SC	Dentist	$0	$2.6M
Summerville Pediatric Dentistry	SC	Pediatric Dentistry	$0	$2.5M
David Castellone	SC	Family Medicine Physician	$605K	$36.6K
Brian Keller	SC	Family Medicine Physician	$398K	$28.3K
Sara Montoya	SC	Family Medicine Physician	$388.5K	$0
Emily Kmetz	SC	Dermatology Physician	$332K	$0

Roper Saint Francis Physicians Network — 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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