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.

Pal-med, LLC (NPI 1457304461)

Field	Value
Entity Type	Organization
Organization	Pal-med, LLC
Address	454 Berryhill Rd Ste B
City	Columbia
State	SC
ZIP	29210
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$26.2M
Medicare	$0

Key Findings

This entity has no Medicare billing on file and reports $26.2M in lifetime Medicaid revenue, making it effectively a Medicaid-focused DME/supplies provider rather than a mixed-payer supplier. The absence of Medicare activity eliminates revenue diversification from that federal payer and concentrates the organization’s exposure to state Medicaid reimbursement policies and enrollment dynamics.

The provider’s code mix is strongly centered on diabetes-related durable medical equipment and consumables: the top three Medicaid codes are A9276 (sensor for interstitial CGM), A4230 (infusion set for external insulin pump), and A9277 (CGM transmitter), with reported volumes of 32.5K claims/$8.5M (32.4%), 32.7K claims/$5.2M (19.7%), and 7.5K claims/$3.4M (12.9%) respectively. These codes and claim counts indicate the operation supplies both hardware (transmitters/receivers) and large volumes of recurring disposables, consistent with a business model serving chronic diabetes management.

Revenue is highly concentrated: the precomputed top-three codes account for 65.0% of the provider’s Medicaid revenue. That level of concentration suggests the firm’s financial performance is closely tied to reimbursement and utilization trends for CGM and insulin-pump supplies rather than a broad DME product portfolio.

State-level competitive standing is strong for core diabetes products. The provider ranks #1 in-state for A9276 and A4230 (each #1 of 2 providers in-state; annotated as 100th percentile; typical, unremarkable volume), and it is the top or sole in-state reporter for several other CGM/insulin pump items (e.g., A9277 and A9274 are listed #1 of 1 providers in-state with no state peer volume comparison available), indicating it is a leading supplier of these product lines within South Carolina.

Several supply codes show unusually high relative state volumes on specific measures: A4253 (blood glucose test strips) is #1 of 9 providers in-state and flagged as "notably above typical state volume," and additional items such as A5120 and A4259 are also described as "notably above typical." These annotations imply the provider not only supplies higher-priced CGM hardware but also captures above-normal share in routine consumables that drive recurring claims.

The claim-level pattern reinforces a high-volume consumables business: multiple supply codes report large claim counts with modest per-claim payments (for example, K0552: 19.4K claims/$524.4K; K0553: 15.8K claims/$284.3K; A4253: 12.9K claims/$1.1M). This mix—many low-dollar, high-frequency claims alongside higher-dollar device claims—fits a fulfillment/dispensing operation that relies on recurring monthly or periodic supply replenishment.

Operational and contracting implications follow from the data: dependence on Medicaid ($26.2M) and the CGM/insulin supply ecosystem concentrates revenue and may increase sensitivity to state policy changes, prior-authorization rules, or shifts in device utilization. The lack of Medicare billing reduces alternative payer leverage and suggests analysts should prioritize Medicaid rate-setting, medical necessity criteria for CGM/insulin therapies, and supplier enrollment/credentialing in competitive assessments.

The provider has a long tenure based on its NPI enumeration date of 2006-05-19 (~20 years ago), which indicates an established presence in the market and potentially mature operational relationships with clinics, pharmacies, or state Medicaid administrators that support high-volume recurring supply distribution.

Medicaid: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	32,500	$260	$8.5M
A4230	Infusion set for external insulin pump, non needle cannula type	32,720	$160	$5.2M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	7,520	$450	$3.4M
E0784	External ambulatory infusion pump, insulin	8,170	$340	$2.7M
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	7,500	$320	$2.4M
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	12,890	$90	$1.1M
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1,650	$440	$722.2K
K0552	Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each	19,420	$30	$524.4K
A4225	Supplies for external insulin infusion pump, syringe type cartridge, sterile, each	12,770	$30	$408.5K
A6257	Transparent film, sterile, 16 sq. in. or less, each dressing	16,230	$30	$405.6K

Showing 1–10 of 32

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

Pal-med, LLC — 10 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

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	1	10	19,530	$220	$4.3M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	7,520	$450	$3.4M
A4230	Infusion set for external insulin pump, non needle cannula type	1	10	18,970	$160	$3M
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	1	10	7,500	$320	$2.4M
E0784	External ambulatory infusion pump, insulin	1	10	5,940	$310	$1.8M
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	1,650	$440	$722.1K
K0552	Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each	1	10	19,420	$30	$517.4K
A6257	Transparent film, sterile, 16 sq. in. or less, each dressing	1	10	16,230	$20	$401.8K
A4225	Supplies for external insulin infusion pump, syringe type cartridge, sterile, each	1	10	10,870	$30	$322.5K
K0553	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	1	10	15,800	$20	$278K

Showing 1–10 of 32

Nearby Providers

Other providers in the same ZIP code as Pal-med, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Youth Advocate Program	SC	Community/Behavioral Health Agency	$0	$64M
Lifehme, Inc.	SC	Oxygen Equipment & Supplies (DME)	$0	$45.6M
Bright Start, LLC	SC	Speech-Language Pathologist	$0	$20.8M
Kids First Dental, LLC	SC	Dentist	$0	$20.6M
Hospice Care Of South Carolina, Lowcountry, LLC	SC	Community Based Hospice Care Agency	$0	$19.9M
Crescent Hospice, Inc.	SC	Community Based Hospice Care Agency	$0	$17.3M
Coram Healthcare/carolina Home Therapeutics	SC	Home Infusion Therapy Pharmacy	$0	$13.9M
Caring Healthcare, Inc.	SC	Nursing Care Agency	$0	$13.3M
Richland/lexington Disabilities And Special Needs Board	SC	Case Management Agency	$0	$11.3M
Compassionate Care Hospice Of South Carolina, LLC	SC	Community Based Hospice Care Agency	$0	$9.6M

Pal-med, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References