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.

Midlands Neurology & Pain Assoc, P.A (NPI 1629084132)

Midlands Neurology & Pain Assoc, P.A is a interventional pain medicine physician provider located in Columbia, South Carolina. This profile covers 0 Medicare and 42 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Midlands Neurology & Pain Assoc, P.A
Address	2601 Millwood Ave
City	Columbia
State	SC
ZIP	29205
Taxonomy	Interventional Pain Medicine Physician
NPI Enumerated	August 1, 2006

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

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

42 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…	24,800	$60	$1.4M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	17,100	$30	$530K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	16,190	$20	$388.5K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	180	$440	$80.2K
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…	1,550	$40	$63.4K
99205	The provider sees a new 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 provider…	430	$100	$42.5K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	1,210	$10	$8.4K
92546	The provider measures various parameters of normal and pathological vestibular systems and also estimates the patient's visual acuity by checking the visual–vestibular interaction using sinusoidal…	190	$40	$7K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	90	$80	$6.8K
92540	The provider performs four specific tests, with recording, to check balance disorders. This code represents both the technical and professional components of the service.	160	$40	$5.8K

Showing 1–10 of 42

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

Midlands Neurology & Pain Assoc, P.A — 5 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

42 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	276	290	2,600	$60	$414.4K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	15	160	270	$70	$268.1K
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…	712	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	514	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…	51	2,480	350	$80	$246K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	18	60	520	$70	$182.7K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	8	160	1,480	$30	$126.4K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	2	10	130	$440	$95.4K
86703	The lab analyst performs an immunoassay to evaluate the patient’s specimen, typically serum, for antibodies to HIV 1 or HIV 2. This code applies to a single result for either antibody.	14	10	180	$40	$67.1K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	40	60	300	$40	$60K

Showing 1–10 of 42

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eleanya Ogburu-ogbonnaya	SC	Neurology Physician	$244.2K	$297.5K
Austin Kuhn	SC	Clinical Social Worker	$48.2K	$21.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mental Illness Recovery Center	SC	Community/Behavioral Health Agency	$0	$6M
Aneta Hopkins	SC	Professional Counselor	$0	$2.3M
James Floyd	SC	Physical Therapist	$326.3K	$0
South Carolina Cvs Pharmacy LLC	SC	Pharmacy	$232.5K	$0
Tab Thompson	SC	Otology & Neurotology Physician	$180.1K	$0
Anna Bouknight	SC	Otolaryngology Physician	$160.4K	$0
David Matthews	SC	Optometrist	$87.3K	$0
Cynthia Martinez	SC	Family Nurse Practitioner	$77.5K	$0
John Shires	SC	Physician Assistant	$18.7K	$0

Midlands Neurology & Pain Assoc, P.A — Billing Profile & Reimbursement Data

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Midlands Neurology & Pain Assoc, P.A — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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