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NPI 1477510022 · Charleston, SC · Family Medicine Physician
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Thomas Arnau is a family medicine physician provider located in Charleston, South Carolina. This profile covers 138 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Thomas Arnau |
| Address | 9313 Medical Plaza Dr |
| City | Charleston |
| State | SC |
| ZIP | 29406 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | April 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.4M |
| Medicaid | $27K |
Medicare dominates this provider's public payer footprint: total Medicare revenue is $2.4M while total Medicaid revenue is $27K, indicating an effectively Medicare-focused practice in scale and reimbursement. Medicaid is present but represents only a small fraction of billed public-payer dollars, so strategic and utilization patterns will be driven largely by Medicare activity rather than Medicaid case mix.
Medicare revenue is concentrated in routine laboratory testing: the top three Medicare codes (80061, 80053, 84443) together account for 43.5% of the provider's Medicare revenue. Those three codes are all high-volume diagnostic panels or endocrine screening tests, which points to a revenue base built on frequent lab ordering and follow-up rather than high-acuity office procedures.
The specific code mix signals a primary care / chronic disease management orientation with strong on-site or closely integrated lab services. High-revenue lab codes such as 80061, 80053, 83036 (A1C), 85025 (CBC), and 82306 (vitamin D) dominate the top-paid services, and the presence of 36415 (blood draw) with 5.6K claims supports significant phlebotomy throughput that is consistent with routine monitoring of diabetes, lipids, thyroid, and vitamin D.
On national competitive standing for Medicare lab services, this provider is a high-volume outlier on several measures: 83036 (A1C) is described as an "extreme outlier, far above typical national volume" (rank #73 of 44997, 100th percentile), while 80061 and 80053 both rank in the top percentiles nationally (80061: #78 of 21671, 100th percentile; 80053: #95 of 26416, 100th percentile) and are labeled "notably above typical national volume." These ranks indicate the provider is a major national participant for routine laboratory testing codes rather than a modest local biller for those services.
By contrast, the provider's Medicaid activity is modest and concentrated: the top three Medicaid codes (80053, 80061, 84443) account for 49.5% of Medicaid revenue, but each of those codes sits near or below median in-state rank (80053 at the 40th percentile, 80061 at the 48th percentile, 84443 at the 36th percentile). This pattern indicates that while the same diagnostic panel services drive Medicaid revenue, the provider is not a dominant Medicaid lab services outlier within South Carolina.
Operationally, the mix of high-volume lab panels plus notable payments for procedural imaging and diagnostics (examples in Medicare include 93880 duplex vascular ultrasound, 93306 echocardiography, 72148 lumbar MRI, 71271 LDCT) suggests the practice offers or coordinates a broad set of diagnostic services beyond basic office visits. The combination of frequent lab panels and select imaging/screening codes implies care pathways focused on chronic disease surveillance and preventive screening.
The provider exhibits a long tenure on file: NPI enumerated 2006-04-27 (~20 years ago), which supports interpretation of these high-volume patterns as established practice behavior rather than a transient billing spike. Longitudinal presence may reflect stable referral networks or embedded workflows for lab-based monitoring.
Several individual-code labels flag how this provider compares to peers: besides the "extreme outlier" designation for 83036, multiple Medicare codes are marked as "notably above typical national volume" (e.g., 80061, 80053, 85025) or high-percentile (82306, 80048, 85027). Taken together, these code-level descriptors corroborate that the provider is a consistent high-volume user of routine laboratory tests nationally while remaining a modest Medicaid participant within state peer groups.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
138 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 26,510 | $10 | $344.7K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 30,500 | $10 | $305K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 16,870 | $20 | $270K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 22,710 | $10 | $227.1K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 24,310 | $10 | $194.5K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 6,660 | $30 | $193.1K |
| 84481 | The lab analyst performs a test to measure free T3 in patient blood. | 3,350 | $20 | $56.9K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 6,090 | $10 | $54.8K |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 2,730 | $20 | $51.9K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 2,990 | $20 | $44.8K |
Showing 1–10 of 138
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 138 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
138 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 93306 | 123 | 450 | 230 | $80 | $23.9K |
| 99214 | 3,545 | 7,860 | 160 | $80 | $23.2K |
| A9500 | 111 | 110 | 170 | $90 | $18.7K |
| G0439 | 1,318 | 1,870 | 80 | $120 | $14.5K |
| 99213 | 3,744 | 7,690 | 100 | $60 | $10.8K |
| 70553 | 156 | 220 | 50 | $110 | $10.4K |
| 93880 | 20 | 360 | 60 | $80 | $8.2K |
| 86003 | 5 | 10 | 1,720 | $10 | $8.2K |
| 72148 | 30 | 330 | 50 | $80 | $7.6K |
| 70450 | 168 | 360 | 180 | $30 | $6.9K |
Showing 1–10 of 138
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 530 | $10 | $4.8K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 360 | $10 | $4.3K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 390 | $10 | $4.2K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 410 | $10 | $2.9K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 120 | $20 | $2.6K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 310 | $10 | $2.4K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 120 | $10 | $1.3K |
| 84481 | The lab analyst performs a test to measure free T3 in patient blood. | 90 | $20 | $1.3K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 150 | $10 | $1K |
| 82728 | The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute… | 50 | $10 | $560 |
Showing 1–10 of 17
How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Carolina median
17 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 127 | 210 | 1,470 | $60 | $615K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 539 | 710 | 350 | $60 | $247.2K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 65 | 100 | 310 | $20 | $39.5K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 239 | 420 | 710 | $1 | $24.5K |
| 85027 | The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the… | 117 | 150 | 780 | $1 | $20K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 94 | 180 | 400 | $10 | $18.1K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 97 | 150 | 1,070 | $1 | $17K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 77 | 100 | 880 | $10 | $16.4K |
| 82570 | The lab analyst measures the amount of creatinine, in a patient specimen, other than blood. Creatinine is the waste material generated by the muscle tissue produced from the breakdown of creatine… | 90 | 90 | 470 | $10 | $15.8K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 125 | 280 | 190 | $10 | $12.4K |
Showing 1–10 of 17
Other providers in the same ZIP code as Thomas Arnau, ranked by combined Medicare and Medicaid revenue.
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