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.

Piedmont Childrens Clinic (NPI 1699831321)

Piedmont Childrens Clinic is a pediatrics physician provider located in Anderson, South Carolina. This profile covers 0 Medicare and 50 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	Piedmont Childrens Clinic
Address	2000 E Greenville St
City	Anderson
State	SC
ZIP	29621
Taxonomy	Pediatrics Physician
NPI Enumerated	December 28, 2006

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

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

50 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	25,870	$70	$1.7M
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…	8,300	$90	$755K
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…	6,820	$100	$675K
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…	6,790	$90	$625K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,090	$100	$493.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,920	$110	$306.8K
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.	16,010	$20	$288.1K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	10,310	$30	$268.1K
G9153	Mapcp demonstration - physician incentive pool	5,590	$40	$245.8K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	7,090	$20	$163.2K

Showing 1–10 of 50

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

Piedmont Childrens Clinic — 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

50 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…	34	280	600	$90	$299K
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…	104	2,770	210	$60	$254.5K
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…	187	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…	31	380	160	$100	$226.8K
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…	261	410	330	$50	$152.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	27	390	100	$100	$148.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	30	340	110	$110	$107.9K
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.	32	650	140	$30	$98.1K
G9153	Mapcp demonstration - physician incentive pool	12	140	420	$50	$91.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	92	140	270	$60	$89.1K

Showing 1–10 of 50

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anmed Health	SC	General Acute Care Hospital	$0	$75.9M
Palmetto Seating And Mobility, Inc.	SC	Durable Medical Equipment & Medical Supplies	$0	$44.7M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$40.9M
Creston Dental-1, P.C.	SC	General Practice Dentistry	$0	$14.8M
Southern Home Care Services, Inc.	SC	In Home Supportive Care Agency	$0	$14.1M
Medshore Ambulance Service, LLC	SC	Ambulance	$6.4M	$7M
Bryant Pharmacy & Supply	SC	Durable Medical Equipment & Medical Supplies	$0	$11.4M
Labtech Diagnostic, LLC	SC	Clinical Medical Laboratory	$0	$10.7M
Anmed Health	SC	Pediatrics Physician	$0	$10.3M
Upstate Medical Staffing, Inc.	SC	In Home Supportive Care Agency	$0	$9.3M

Piedmont Childrens Clinic — Billing Profile & Reimbursement Data

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Piedmont Childrens Clinic — 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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Frequently Asked Questions

References