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    v1.0.28
    OpenPayerNPI Medicare & MedicaidSanjay Kumar
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    Sanjay Kumar — Billing Profile & Reimbursement Data

    NPI 1275632309 · Walterboro, SC · Internal Medicine Physician

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    Sanjay Kumar is a internal medicine physician provider located in Walterboro, South Carolina. This profile covers 19 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationSanjay Kumar
    Address461 Spruce St
    CityWalterboro
    StateSC
    ZIP29488
    TaxonomyInternal Medicine Physician
    NPI EnumeratedSeptember 22, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$195.8K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…970$80$80.1K
    90960The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…240$260$63.1K
    90961The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…50$230$12.2K
    99232The 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…140$60$8K
    99204The 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…50$110$5.7K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…60$90$5.6K
    90935Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…60$50$3.3K
    99490The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…60$50$2.9K
    90674This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…80$30$2.6K
    93306The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…20$140$2.4K

    Showing 1–10 of 19

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    19 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9096045130180$270$53.7K
    93306399450230$80$23.9K
    992144417,860160$80$23.2K
    992321,0832,78090$60$12K
    909613513040$220$10.3K
    9949039965080$40$8.9K
    992231,9182,08040$130$8.3K
    992041,6834,52040$110$6.4K
    909357213070$50$5.1K
    992223791,83030$90$4.2K

    Showing 1–10 of 19

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Colleton County Board Of Disabilities And Special NeedsSCIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$16.7M
    Walterboro Community Hospital, Inc.SCGeneral Acute Care Hospital$0$11.8M
    Walterboro Family Practice Associates, P.A.SCFamily Medicine Physician$0$7M
    Colleton County School DistrictSCSpeech-Language Pathologist$0$3.1M
    Walterboro Adult & Pediatric Medicine, LLCSCRural Health Clinic/Center$0$2.2M
    Genesis Health Care, IncSCFederally Qualified Health Center (FQHC)$0$2.1M
    County Of ColletonSCAmbulance$518.9K$1.5M
    Genesis Healthcare, IncSCFederally Qualified Health Center (FQHC)$0$1.9M
    Beacon Respiratory Services Of Georgia, IncSCOxygen Equipment & Supplies (DME)$0$1.7M
    Med-trans CorporationSCAir Ambulance$544K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. South Carolina Distribution
    Sanjay Kumar — 0 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina