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.

Allergy Asthma Sinus Ctr (NPI 1700882388)

Allergy Asthma Sinus Ctr is a allergy & immunology physician provider located in Florence, South Carolina. This profile covers 0 Medicare and 15 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	Allergy Asthma Sinus Ctr
Address	800 E Cheves St
City	Florence
State	SC
ZIP	29506
Taxonomy	Allergy & Immunology Physician
NPI Enumerated	June 28, 2005

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	17,100	$230	$3.8M
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	10,500	$170	$1.7M
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	90,200	$10	$631.4K
99204	The provider sees a new 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 provider…	4,720	$120	$542.8K
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…	8,700	$50	$434.8K
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…	5,050	$70	$348.1K
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…	2,290	$130	$302.8K
95115	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives a single injection during the visit.	25,380	$10	$152.3K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	2,860	$20	$57.2K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	870	$60	$54.7K

Showing 1–10 of 15

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

Allergy Asthma Sinus Ctr — 5 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	2	40	120	$220	$367.6K
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…	252	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…	304	2,480	350	$80	$246K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1	30	860	$130	$203.7K
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…	9	110	70	$150	$157.3K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	15	30	170	$120	$120.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	103	610	190	$50	$98.4K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	18	270	120	$50	$93.2K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	3	10	140	$130	$87.2K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	60	70	120	$100	$83K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danny Douglas	SC	Allergy & Immunology Physician	$178K	$20.5K
Joseph Moyer	SC	Allergy & Immunology Physician	$134.8K	$35.7K
Stephen Imbeau	SC	Allergy & Immunology Physician	$132.9K	$11.5K
Harry Stone	SC	Allergy & Immunology Physician	$53K	$32.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mcleod Regional Medical Center Of The Pee Dee, Inc.	SC	General Acute Care Hospital	$0	$90.9M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$47.7M
Florence County Disabilities And Special Needs Board	SC	Early Intervention Provider Agency	$0	$28.3M
Mcleod Physician Associates Ii	SC	Pediatrics Physician	$0	$13.1M
Mcleod Regional Medical Center Of The Pee Dee, Inc	SC	Emergency Medical Services (Emergency Medicine) Physician	$0	$12.7M
County Of Florence	SC	Land Ambulance	$2M	$4.5M
Mcleod Physician Associates Ii	SC	Obstetrics & Gynecology Physician	$0	$6.4M
Florence School District One	SC	Local Education Agency (LEA)	$0	$6.3M
Tucker-wells Medical, Inc.	SC	Durable Medical Equipment & Medical Supplies	$0	$5.8M
Mcleod Regional Medical Center Of The Pee Dee, Inc.	SC	Community Based Hospice Care Agency	$0	$5.7M

Allergy Asthma Sinus Ctr — Billing Profile & Reimbursement Data

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Allergy Asthma Sinus Ctr — 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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