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 Associates Of The Medical University Of South Carol (NPI 1396896346)

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

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	16,510	$50	$891.3K
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…	16,610	$50	$747.3K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	5,260	$80	$399.7K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	5,980	$60	$346.6K
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…	3,080	$60	$194.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,190	$60	$181.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,510	$60	$157.9K
99222	The 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…	1,550	$100	$153.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,560	$80	$131.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,970	$60	$118.1K

Showing 1–10 of 26

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 Associates Of The Medical University Of South Carol — 3 of 25 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	68	280	600	$90	$299K
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…	148	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…	461	2,480	350	$80	$246K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	80	380	160	$100	$226.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	73	390	100	$100	$148.3K
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…	12	230	430	$40	$129.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	78	340	110	$110	$107.9K
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,…	430	610	190	$50	$98.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	21	120	220	$60	$86.2K
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…	35	70	120	$100	$83K

Showing 1–10 of 26

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Medical Associates Of The Medical University Of South Carol, 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
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
Rosalee Unwin	SC	Family Nurse Practitioner	$2.9M	$0

Nearby Providers

Other providers in the same ZIP code as University Medical Associates Of The Medical University Of South Carol, 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
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
University Medical Associate Of The Medical University Of South Caroli	SC	Otolaryngology Physician	$0	$2.3M
William Cook	SC	MOHS-Micrographic Surgery Physician	$2.2M	$0
Hao Tang	SC	Retina Specialist (Ophthalmology) Physician	$2.1M	$0

University Medical Associates Of The Medical University Of South Carol — Billing Profile & Reimbursement Data

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University Medical Associates Of The Medical University Of South Carol — 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