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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMeredith Sutton
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    Meredith Sutton — Billing Profile & Reimbursement Data

    NPI 1427699297 · Rock Hill, SC · Acute Care Nurse Practitioner

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    Meredith Sutton is a acute care nurse practitioner provider located in Rock Hill, South Carolina. This profile covers 12 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
    OrganizationMeredith Sutton
    Address500 Lakeshore Pkwy
    CityRock Hill
    StateSC
    ZIP29730
    TaxonomyAcute Care Nurse Practitioner
    NPI EnumeratedOctober 3, 2019

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

    Payer SourceTotal Paid
    Medicare$34.5K
    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.

    12 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…180$70$12.5K
    99497The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…90$50$4.4K
    99496The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…20$170$4K
    G0181Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and…50$70$3.4K
    99348The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…70$30$2.3K
    99350The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…20$100$2K
    99345The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…10$130$1.8K
    99309The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…20$60$1.2K
    G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review…30$30$990
    99347The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at…50$20$740

    Showing 1–10 of 12

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    12 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99349298530240$80$30.4K
    99309438470290$70$29.9K
    9935015921040$120$9.9K
    9949722271050$60$5K
    9949610830020$190$5K
    99345648030$130$4.8K
    993489632040$50$4.1K
    G018162040$70$3.2K
    99347277040$30$2.7K
    9944215517020$50$2.3K

    Showing 1–10 of 12

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    South Carolina Dept Of Mental Health Accounting OfficeSCMental Health Clinic/Center (Including Community Mental Health Center)$0$30.2M
    Community Medicine FoundationSCFederally Qualified Health Center (FQHC)$0$11.3M
    Dental Access Carolina, LLCSCGeneral Practice Dentistry$0$10.9M
    Bayada Home Health Care, Inc.SCHome Health Agency$0$6.1M
    Rock Hill Treatment Specialists, IncSCMethadone Clinic$90K$5.3M
    Affinity Health CenterSCFederally Qualified Health Center (FQHC)$0$4.8M
    Carolina Pediatric TherapySCPhysical Therapist$0$4.8M
    Rock Hill School District ThreeSCLocal Education Agency (LEA)$0$3.2M
    York County Adult Day Care Services, Inc.SCAdult Day Care Clinic/Center$0$3M
    Providence Care LLCSCCommunity Based Hospice Care Agency$0$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.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. South Carolina Distribution
    Meredith Sutton — 0 of 12 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina