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.

James Caldwell (NPI 1811911126)

Field	Value
Entity Type	Individual
Organization	James Caldwell
Address	123 W.g. Acker Drive
City	Pickens
State	SC
ZIP	29671
Taxonomy	Family Medicine Physician
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicare	$19.7K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	120	$80	$9.1K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	180	$50	$8.8K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	10	$130	$1.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	10	$30	$350

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

James Caldwell — 1 of 4 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. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	1,094	1,110	130	$130	$20.6K
99284	450	1,170	100	$90	$9.1K
99283	4	820	30	$50	$1.8K
99282	76	110	10	$30	$500

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health University Medical Group	SC	Family Medicine Physician	$0	$171.7M
Anmed Health	SC	General Acute Care Hospital	$0	$75.9M
Anmed Health	SC	Pediatrics Physician	$0	$10.3M
Cannon Memorial Hospital	SC	General Acute Care Hospital	$0	$7.5M
Anmed Health	SC	Pediatrics Physician	$0	$4.5M
Anmed Health Medicus Surgery Center LLC	SC	Ambulatory Surgical Clinic/Center	$974.8K	$2.7M
Anmed Health	SC	Family Medicine Physician	$0	$3.6M
Anmed Health	SC	Pediatrics Physician	$0	$3M
Anmed Health	SC	Obstetrics & Gynecology Physician	$0	$2.5M
Anmed Health	SC	Obstetrics & Gynecology Physician	$0	$2.1M

Nearby Providers

Other providers in the same ZIP code as James Caldwell, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pickens County Ems	SC	Ambulance	$1.2M	$2.2M
Michael Dillard	SC	Internal Medicine Physician	$21K	$0

James Caldwell — Billing Profile & Reimbursement Data

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James Caldwell — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References