Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJohn Fleming
    Ask Trek AI about this page

    John Fleming — Billing Profile & Reimbursement Data

    NPI 1366448771 · Sumter, SC · Family Medicine Physician

    Customize your policy alerts

    Sign up for John Fleming — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    John Fleming is a family medicine physician provider located in Sumter, South Carolina. This profile covers 11 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJohn Fleming
    Address1229 Alice Dr
    CitySumter
    StateSC
    ZIP29150
    TaxonomyFamily Medicine Physician
    NPI EnumeratedJune 22, 2005

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

    Payer SourceTotal Paid
    Medicare$51.9K
    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.

    11 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…500$80$37.8K
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.390$10$3.1K
    99213The 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…50$60$2.8K
    99215The 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…20$120$2K
    82044Office or lab personnel will usually perform a semiquantitative urine albumin or microalbumin by using a reagent strip that is able to detect the analyte without the use of a chemistry analyzer or…280$10$1.7K
    83036Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…130$10$1.2K
    93000The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…130$10$1K
    81001Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…310$1$940
    94375The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…30$20$670
    99211An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.20$20$320

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992141,4467,860160$80$23.2K
    992135,1787,690100$60$10.8K
    992151,9732,36040$120$9.3K
    94375132080$30$7.1K
    364154702,090140$10$2.7K
    830363731,34070$10$1.5K
    930003781,47030$10$1.5K
    9921125736030$10$880
    810017850060$1$640
    J3301436710170$1$470

    Showing 1–10 of 11

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Anthony ZamchoSCHospitalist Physician$412.9K$0
    Scott GirardNCInternal Medicine Physician$215.3K$0
    Tolulola AdeolaNCHospitalist Physician$191K$0
    Justin MitchellFLHospitalist Physician$98K$0
    Michael NaylorSCVascular Surgery Physician$96.8K$0
    Winston MorrisSCFamily Medicine Physician$59.9K$3.9K
    Glen HybargerWYInternal Medicine Physician$34.3K$0
    Masood KhanNCCardiovascular Disease Physician$13.3K$940

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$28.1M
    Sumter Pediatrics, P.A.SCPediatrics Physician$0$24.4M
    Tandem Health ScSCFederally Qualified Health Center (FQHC)$0$17.3M
    Colonial Family Practice, LLCSCFamily Medicine Physician$0$9.5M
    Tandem Health ScSCFederally Qualified Health Center (FQHC)$0$7.8M
    Prisma Health TuomeySCEmergency Medicine Physician$0$6.8M
    Wesmark Dental Health CenterSCGeneral Practice Dentistry$0$6.3M
    Addus Healthcare (south Carolina), Inc.SCIn Home Supportive Care Agency$0$5.5M
    Carolina Children's Dentistry, LLCSCPediatric Dentistry$0$5.2M
    Sumter School DistrictSCLocal Education Agency (LEA)$0$4.2M

    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.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. South Carolina Distribution
    John Fleming — 1 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina