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.

Musc Affiliate Physicians (NPI 1548849482)

Field	Value
Entity Type	Organization
Organization	Musc Affiliate Physicians
Address	171 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	Family Medicine Physician
NPI Enumerated	April 7, 2021

Payer Source	Total Paid
Medicaid	$14.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

78 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…	69,710	$100	$6.6M
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…	29,790	$70	$1.9M
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…	14,360	$90	$1.3M
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…	11,580	$100	$1.1M
0241U	N/A	7,130	$130	$926.6K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	22,580	$40	$925.9K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2,760	$140	$389.3K
G9153	Mapcp demonstration - physician incentive pool	7,620	$40	$327.5K
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…	1,810	$130	$240.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,140	$100	$205.2K

Showing 1–10 of 78

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

Musc Affiliate Physicians — 7 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

78 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…	15	280	600	$90	$299K
0241U	N/A	8	50	1,840	$90	$291.4K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	16	60	540	$110	$271.5K
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…	80	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	115	710	350	$60	$247.2K
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…	11	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…	17	380	160	$100	$226.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	75	100	240	$100	$187.3K
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…	84	110	70	$150	$157.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	357	410	330	$50	$152.6K

Showing 1–10 of 78

Related Providers

Other providers that share a Tax Identification Number (TIN) with Musc Affiliate Physicians, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Melanie Greene	SC	Internal Medicine Physician	$191.6K	$0
Ann Meade	SC	Internal Medicine Physician	$180.6K	$0
Sarah Carter	SC	Internal Medicine Physician	$152K	$0
Lisa Colasurdo	SC	Family Nurse Practitioner	$148.1K	$0
Kevin Boyter	SC	Family Nurse Practitioner	$145.2K	$0
Elizabeth Barrett	SC	Family Medicine Physician	$142K	$0
James Mcalpine	SC	Internal Medicine Physician	$122.6K	$0
Caitlan Tucker	SC	Physician Assistant	$90.8K	$0
Paige Rostin	SC	Family Nurse Practitioner	$78.8K	$0
Ellen Norman	SC	Medical Physician Assistant	$62.1K	$0

Nearby Providers

Other providers in the same ZIP code as Musc Affiliate Physicians, 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
University Medical Associates Of The Medical University Of South Carol	SC	Family Medicine Physician	$0	$56.6M
Medical University Hospital Authority	SC	Psychologist	$0	$32.6M
Medical University Hospital Authority	SC	Pediatrics Physician	$0	$12.4M
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
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
University Medical Associates Of The Medical University Of South Carol	SC	Psychiatry Physician	$0	$3.3M

Musc Affiliate Physicians — Billing Profile & Reimbursement Data

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Musc Affiliate Physicians — 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