Loading...
NPI 1194729715 · Spartanburg, SC · Internal Medicine Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Pranay Patel is a internal medicine physician provider located in Spartanburg, South Carolina. This profile covers 24 Medicare and 1 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 | Individual |
| Organization | Pranay Patel |
| Address | 3070 Reidville Rd |
| City | Spartanburg |
| State | SC |
| ZIP | 29301 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | June 10, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $92.8K |
| Medicaid | $140 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 500 | $80 | $40.6K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 110 | $120 | $14K |
| 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… | 150 | $60 | $9.1K |
| 99495 | The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,… | 20 | $160 | $3.6K |
| 99443 | N/A | 30 | $90 | $3K |
| 80305 | The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes… | 240 | $10 | $2.9K |
| 90662 | This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection… | 30 | $70 | $2.4K |
| 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… | 230 | $10 | $2.3K |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 90 | $20 | $2.1K |
| G0008 | Administration of influenza virus vaccine | 70 | $30 | $1.9K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 1,437 | 7,860 | 160 | $80 | $23.2K |
| G0439 | 697 | 1,870 | 80 | $120 | $14.5K |
| 99213 | 2,848 | 7,690 | 100 | $60 | $10.8K |
| 99490 | 531 | 650 | 80 | $40 | $8.9K |
| 90662 | 880 | 1,370 | 50 | $70 | $5.5K |
| 92250 | 343 | 420 | 70 | $20 | $3.5K |
| G0008 | 1,086 | 2,330 | 60 | $30 | $3.1K |
| G0446 | 86 | 180 | 80 | $20 | $3.1K |
| 99495 | 113 | 400 | 20 | $150 | $3.1K |
| 99443 | 20 | 70 | 20 | $80 | $3K |
Showing 1–10 of 24
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80305 | The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes… | 20 | $10 | $140 |
How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Carolina median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 80305 | The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes… | 79 | 90 | 160 | $10 | $8.2K |
Other providers in the same ZIP code as Pranay Patel, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Advanced Therapy Solutions, Inc. | SC | Physical Therapist | $0 | $9.5M |
| D Jensen Turner Dmd LLC | SC | Pediatric Dentistry | $0 | $8.2M |
| Spartanburg Medical Center | SC | Urgent Care Clinic/Center | $0 | $6.3M |
| Pediatrics Unlimited Inc | SC | Music Therapist | $0 | $5.9M |
| Mcculloh Therapeutic Solutions | SC | Speech-Language Pathologist | $0 | $4.3M |
| Spartanburg Medical Center | SC | Urgent Care Clinic/Center | $0 | $3.7M |
| Spartanburg Medical Center | SC | Pediatrics Physician | $0 | $2.9M |
| Adam Blumer | SC | Oral and Maxillofacial Surgery (Dentist) | $0 | $1.8M |
| Lee Taylor | SC | Family Medicine Physician | $1.1M | $0 |
| Mark Knipfer | SC | Family Medicine Physician | $406.6K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.