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.

John Wharton (NPI 1386752327)

Field	Value
Entity Type	Individual
Organization	John Wharton
Address	171 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	Clinical Cardiac Electrophysiology Physician
NPI Enumerated	August 29, 2006

Payer Source	Total Paid
Medicare	$133.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

17 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…	660	$80	$50.1K
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…	450	$50	$24.2K
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…	120	$100	$12.8K
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…	80	$120	$10K
93298	The provider, who is a physician or other qualified healthcare professional, evaluates the data from a previously implanted subcutaneous cardiac rhythm monitor system via telemetric communication for…	480	$20	$8.6K
99205	The provider sees a new 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 provider…	40	$150	$5.5K
93294	The provider, a physician or other qualified health care professional, remotely analyzes, for a period up to 90 days, the function of a single, dual, multiple lead, or leadless pacemaker system,…	270	$20	$5.4K
93228	In this procedure, the provider reviews and interprets data collected from the continuous recording and transmission of electrocardiographic data to detect abnormal heart rates and rhythms. He…	160	$20	$3.1K
33285	The provider inserts a cardiac rhythm monitor with self–contained electrodes into a pocket in the tissues beneath the patient's skin and programs the device according to manufacturer’s directions.	40	$70	$2.8K
93295	In this service the provider evaluates from a remote location an implantable single, dual, or multiple lead defibrillator system. The service includes his interim analyses during a period of up to 90…	110	$30	$2.8K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

John Wharton — 1 of 17 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

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33285	8	40	20	$910	$25.5K
99214	964	7,860	160	$80	$23.2K
99213	815	7,690	100	$60	$10.8K
99215	623	2,360	40	$120	$9.3K
99204	533	4,520	40	$110	$6.4K
99205	340	1,000	30	$150	$5.8K
93294	46	200	130	$20	$4.6K
93298	17	130	140	$20	$4.3K
93295	32	110	60	$30	$4K
93297	45	90	110	$20	$3.9K

Showing 1–10 of 17

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$241.1M
University Medical Associates Of The Medical University Of South Carol	SC	Family Medicine Physician	$0	$56.6M
Medical University Hospital Authority	SC	Psychologist	$0	$32.6M
Musc Affiliate Physicians	SC	Family Medicine Physician	$0	$14.7M
Medical University Hospital Authority	SC	Pediatrics Physician	$0	$12.4M
University Medical Associates	SC	Pediatrics Physician	$0	$9.2M
University Medical Associates Of The Medical University Of South Carol	SC	Obstetrics & Gynecology Physician	$0	$6.1M
University Medical Associates Of The Medical University Of South Carol	SC	Diagnostic Radiology Physician	$0	$5.4M
University Medical Associates Of The Medical University Of South Carol	SC	Emergency Medicine Physician	$0	$3.6M
University Medical Associates Of The Medical University Of South Carol	SC	Pediatrics Physician	$0	$3.5M

John Wharton — Billing Profile & Reimbursement Data

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John Wharton — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References