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.

Susan Yonce (NPI 1215994009)

Field	Value
Entity Type	Individual
Organization	Susan Yonce
Address	316 Calhoun St
City	Charleston
State	SC
ZIP	29401
Taxonomy	Family Nurse Practitioner
NPI Enumerated	April 27, 2006

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

This provider’s Medicare business is highly concentrated: total Medicare revenue is $2.3M and the precomputed top 3 Medicare codes account for 79.3% of that revenue. The dominant share indicates a practice model centered on a small number of high-revenue injectable therapies rather than a broad mix of outpatient evaluation-and-management visits or procedure codes.

The code mix and descriptions point to an infusion/injection-focused service line. The top codes are J3111 (romosozumab injection), J3245 (tildrakizumab), and J3380 (vedolizumab), which together suggest routine administration of specialty biologic agents and in-office infusion/immunotherapy services as primary clinical activities.

J3111 is a clear statistical outlier: it generated $925.7K (40.4% of Medicare revenue) and the provider ranks #11 of 970 nationally (99th percentile). This places the provider far above typical national volume for that specific product, indicating either a very high local demand for romosozumab or a concentrated specialization in that medication.

J3245 and J3380 are meaningful secondary revenue drivers, contributing $528K (23.1%) and $362.1K (15.8%) respectively. Both rank within typical national ranges (J3245 at the 67th percentile and J3380 at the 89th percentile), suggesting the provider is a notable but not extreme participant nationally for these biologic infusion therapies.

Several additional administration and chemotherapy-related codes appear in the top 25 but contribute only marginally to revenue individually (for example 96365, 96413, 96372). These codes indicate the practice performs IV administrations and some chemotherapy/infusion services, but those services are not the primary revenue drivers compared with the three biologic injections.

The provider reports no Medicaid billing on file, so payer mix is effectively single-payer Medicare dominated. With Medicaid revenue listed as none, this clinician’s commercial and Medicaid exposure appears minimal or absent in the available public claims data, concentrating financial risk and utilization visibility with Medicare.

Competitive standing is mixed by code: for J3111 the provider is an exceptional high-volume national outlier, while for several other biologic codes the provider’s volumes are within typical national ranges (e.g., J3245 at 67th percentile, J3380 at 89th percentile). This pattern implies a specialized niche in one product with broader, but less extreme, participation across other biologics.

Tenure data shows the NPI was enumerated on 2006-04-27 (about 20 years ago), indicating long-standing Medicare enrollment. That longevity supports stable billing relationships and likely operational experience in administering specialty injectable therapies in the outpatient setting.

A few additional codes are also extreme outliers in volume relative to national peers (for example 96372 and J3489 rank at the 99th percentile nationally). These outlier administration and infusion-related volumes reinforce that the practice operates a high-throughput injection/infusion workflow, which should be a focus for capacity, contracting, and supply-chain considerations.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3111	Injection, romosozumab-aqqg, 1 mg	115,710	$10	$925.7K
J3245	Injection, tildrakizumab, 1 mg	4,800	$110	$528K
J3380	Injection, vedolizumab, intravenous, 1 mg	21,300	$20	$362.1K
J2357	Injection, omalizumab, 5 mg	7,170	$30	$215.1K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3,240	$30	$84.2K
J0897	Injection, denosumab, 1 mg	3,840	$20	$69.1K
J1306	Injection, inclisiran, 1 mg	7,380	$10	$66.5K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	370	$40	$13.5K
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…	880	$10	$7.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	110	$70	$7.8K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Susan Yonce — 3 of 16 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. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3245	5	20	3,800	$110	$435.3K
J3380	4	20	11,400	$20	$231K
J2357	10	30	4,360	$30	$183.8K
J3111	1	40	12,390	$10	$129.4K
J1745	25	50	3,250	$30	$107K
J1306	14	20	8,800	$10	$95.1K
J0897	81	250	2,400	$20	$91.2K
96413	89	150	140	$90	$22.1K
96401	59	70	120	$50	$9.4K
96365	21	170	100	$40	$7.4K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Susan Yonce, ranked by combined Medicare and Medicaid revenue.

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
Weijian Zhu	GA	Anatomic Pathology & Clinical Pathology Physician	$2.6M	$4.7K
Danyel Mcevoy	SC	Anatomic Pathology & Clinical Pathology Physician	$2.3M	$0
Roper Saint Francis Physicians Network	SC	Family Medicine Physician	$0	$1.7M
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

Nearby Providers

Other providers in the same ZIP code as Susan Yonce, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roper Hospital, Inc	SC	General Acute Care Hospital	$0	$22.1M
Charleston County School District	SC	Local Education Agency (LEA)	$0	$12.7M
Michael Spandorfer	SC	Pulmonary Disease Physician	$246.4K	$0
James Carswell	SC	Critical Care Medicine (Internal Medicine) Physician	$222K	$0
Johnny Campbell	SC	Diagnostic Radiology Physician	$213.4K	$0
Jeffery Bennett	SC	Diagnostic Radiology Physician	$201.7K	$0
Robert Lowery	SC	Orthopaedic Surgery Physician	$197.6K	$0
Edward Butler	SC	Procedural Dermatology Physician	$184.7K	$0
Catherine Johnson-gough	SC	Diagnostic Radiology Physician	$179.4K	$0
Andrew Barnes	SC	Neuroradiology Physician	$178.9K	$0

Susan Yonce — Billing Profile & Reimbursement Data

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Susan Yonce — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References