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.

University Medical Associate Of The Medical University Of South Caroli (NPI 1386795318)

Field	Value
Entity Type	Organization
Organization	University Medical Associate Of The Medical University Of South Caroli
Address	171 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	Otolaryngology Physician
NPI Enumerated	January 16, 2007

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

21 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…	8,470	$80	$686.1K
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…	9,670	$60	$551K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	2,820	$170	$470.3K
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…	1,410	$110	$151.7K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	1,330	$110	$150K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,200	$100	$123.7K
99232	The 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…	890	$50	$44.6K
99203	The provider sees a new 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 provider…	640	$60	$37.6K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	540	$40	$19.5K
31579	The provider uses a flexible or rigid laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. He also performs stroboscopy, which is a method of examination…	420	$40	$18.1K

Showing 1–10 of 21

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

University Medical Associate Of The Medical University Of South Caroli — 1 of 21 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	237	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…	180	2,480	350	$80	$246K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	6	110	70	$150	$157.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	11	50	480	$160	$147.9K
99232	The 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…	84	230	430	$40	$129.9K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	9	30	170	$120	$120.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	590	610	190	$50	$98.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	38	40	140	$220	$87.4K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	9	70	120	$100	$83K
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…	29	360	100	$100	$76.9K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Medical Associate Of The Medical University Of South Caroli, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Medical Associates Of The Medical University Of South Carol	SC	Family Medicine Physician	$0	$56.6M
Musc Community Physicians	SC	Internal Medicine Physician	$0	$16.7M
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
Musc Community Physicians	SC	Family Medicine Physician	$0	$5.6M
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
Edward Mcclay	CA	Medical Oncology Physician	$3.4M	$0
University Medical Associates Of The Medical University Of South Carol	SC	Psychiatry Physician	$0	$3.3M

Nearby Providers

Other providers in the same ZIP code as University Medical Associate Of The Medical University Of South Caroli, 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
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
Rosalee Unwin	SC	Family Nurse Practitioner	$2.9M	$0
Jennifer Douglas	SC	Physician Assistant	$2.9M	$0
University Medical Associates Of The Medical University Of South Carol	SC	Multi-Specialty Clinic/Center	$0	$2.8M
Woodrow Coker	SC	Hospitalist Physician	$2.6M	$0
William Cook	SC	MOHS-Micrographic Surgery Physician	$2.2M	$0
Hao Tang	SC	Retina Specialist (Ophthalmology) Physician	$2.1M	$0

University Medical Associate Of The Medical University Of South Caroli — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References