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.

Covenant Family Allergy, PC (NPI 1205002888)

Covenant Family Allergy, PC is a allergy & immunology physician provider located in North Augusta, South Carolina. This profile covers 0 Medicare and 14 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	Covenant Family Allergy, PC
Address	616 Edgefield Rd
City	North Augusta
State	SC
ZIP	29841
Taxonomy	Allergy & Immunology Physician
NPI Enumerated	May 5, 2008

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.

14 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.	1,950	$400	$776.5K
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…	3,750	$80	$296.2K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	740	$200	$149.2K
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.	14,560	$10	$101.9K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	4,000	$20	$88.1K
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…	740	$120	$85.6K
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…	1,600	$50	$75.1K
95012	The provider performs a test involving nitric oxide exhaled by a patient into a nitric oxide monitoring system. The test helps with checking the level of inflammation in the airways of a patient who…	3,510	$10	$42.1K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	890	$40	$32.9K
94664	The provider educates a patient on the use of an aerosol device, nebulizer, metered dose inhaler, or IPPB device and then has the patient demonstrate her understanding. He does this as part of the…	2,030	$10	$20.3K

Showing 1–10 of 14

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

Covenant Family Allergy, PC — 1 of 14 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	10	40	120	$220	$367.6K
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…	705	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…	398	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.	18	30	860	$130	$203.7K
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…	336	410	330	$50	$152.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	295	360	100	$100	$76.9K
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…	72	490	90	$100	$63.6K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	7	90	140	$50	$58.5K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	6	40	130	$150	$53.9K
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.	12	80	260	$10	$46.2K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Performance Medical Supply Inc	SC	Durable Medical Equipment & Medical Supplies	$0	$3.7M
Deborah A. Ashcraft, D.m.d.,p.c.	SC	Pediatric Dentistry	$0	$2.9M
Steven Van De Graaff	SC	Dentist	$0	$1.9M
All About Children, LLC	SC	Early Intervention Provider Agency	$0	$1.6M
Melinda Forrest	SC	Family Nurse Practitioner	$521.5K	$0
Katherine Embry	SC	Family Medicine Physician	$160.9K	$0
Janeshia Robinson	SC	Nurse Practitioner	$142.2K	$0
Allen Sloan	SC	Pain Medicine (Anesthesiology) Physician	$127.4K	$0
Lorie Stumpo	SC	Diagnostic Radiology Physician	$88.4K	$0
Tuan Nguyen	SC	Physical Therapist	$87.4K	$0

Covenant Family Allergy, PC — Billing Profile & Reimbursement Data

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Covenant Family Allergy, PC — 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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