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.

Piedmont Physician Network LLC (NPI 1194277186)

Piedmont Physician Network LLC is a internal medicine physician provider located in York, South Carolina. This profile covers 0 Medicare and 55 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	Piedmont Physician Network LLC
Address	1023 Creekside Medical Dr
City	York
State	SC
ZIP	29745
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 26, 2016
NPI Deactivated	September 14, 2023

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

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

55 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…	63,930	$60	$4M
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…	30,730	$70	$2.2M
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…	3,000	$50	$152.8K
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…	1,250	$90	$107.7K
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…	730	$140	$99.9K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	1,230	$70	$84.9K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	800	$100	$82.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	920	$90	$80.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	760	$90	$66.9K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	60	$1,040	$64.4K

Showing 1–10 of 55

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

Piedmont Physician Network LLC — 2 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

55 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	25	60	50	$960	$381.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	29	40	510	$170	$302.7K
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…	24	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…	35	2,480	350	$80	$246K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	31	100	240	$100	$187.3K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	14	20	30	$480	$164.8K
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…	89	110	70	$150	$157.3K
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…	115	410	330	$50	$152.6K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	38	110	130	$70	$134.7K
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…	47	230	430	$40	$129.9K

Showing 1–10 of 55

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Outpatient Clinics, Inc.	AZ	Multi-Specialty Clinic/Center	$0	$15.2M
Baptist Health Centers LLC	AL	Specialist	$0	$7M
Baptist Health Centers, LLC	AL	Health Service Clinic/Center	$0	$2.1M
Baptist Health Centers LLC	AL	Internal Medicine Physician	$0	$2M
Baptist Health Centers, LLC	AL	Family Medicine Physician	$0	$990.6K
Rahul Malhotra	AZ	Interventional Cardiology Physician	$778.7K	$0
Rahool Karnik	AZ	Cardiovascular Disease Physician	$695.1K	$0
Nopporn Unnoppet	AL	Rheumatology Physician	$559.5K	$0
John Morgan	AZ	Interventional Cardiology Physician	$507.4K	$0
Jay Kalan	SC	Cardiovascular Disease Physician	$491.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
York County Board Of Disabilities And Special Needs	SC	Developmentally Disabled Services Day Training Agency	$0	$40.2M
York School District One	SC	Local Education Agency (LEA)	$0	$2.3M
Tri-county Pediatrics LLC	SC	Rural Health Clinic/Center	$0	$1.8M
York County Adult Day Care Services, Inc.	SC	Adult Day Care Clinic/Center	$0	$1.7M
Romin Shah	SC	Internal Medicine Physician	$78.9K	$0

Piedmont Physician Network LLC — Billing Profile & Reimbursement Data

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Piedmont Physician Network LLC — 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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