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.

St Francis Physician Services Inc (NPI 1841668670)

St Francis Physician Services Inc is a family medicine physician provider located in Mauldin, South Carolina. This profile covers 0 Medicare and 78 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	St Francis Physician Services Inc
Address	309 W Butler Rd
City	Mauldin
State	SC
ZIP	29662
Taxonomy	Family Medicine Physician
NPI Enumerated	September 10, 2015

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

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…	22,230	$70	$1.6M
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…	18,190	$50	$873.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,610	$90	$136.8K
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…	1,270	$100	$125.5K
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…	1,130	$90	$99.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,040	$90	$93.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	5,510	$10	$71.6K
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.	4,640	$20	$69.5K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	3,820	$10	$49.7K
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…	2,390	$20	$45.4K

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

St Francis Physician Services Inc — 1 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
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	48	90	260	$430	$688.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	125	210	1,470	$60	$615K
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…	162	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…	140	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	92	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…	62	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…	118	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…	325	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.	78	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.	82	340	110	$110	$107.9K

Showing 1–10 of 78

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Self Regional Healthcare	SC	General Acute Care Hospital	$0	$58.8M
Self Medical Group	SC	Emergency Medicine Physician	$0	$6M
Steven Madden	SC	Hematology & Oncology Physician	$4M	$0
Self Medical Group	SC	Pediatrics Physician	$0	$3.3M
Self Medical Group	SC	Urgent Care Clinic/Center	$0	$2.6M
Self Medical Group	SC	Urgent Care Clinic/Center	$0	$2.2M
Kalpesh Purohit	SC	Family Medicine Physician	$2.1M	$0
Kenneth Spearman	CA	Vascular & Interventional Radiology Physician	$1.9M	$0
Michael Schekall	MN	Diagnostic Radiology Physician	$1.7M	$710
Christina Smith	SC	Family Nurse Practitioner	$1.5M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tiny Feet Early Intervention	SC	Early Intervention Provider Agency	$0	$6.1M
Navis Pad	SC	Physical Disabilities Residential Treatment Facility	$0	$2.6M
Upstate Pediatric Speech Therapy Services	SC	Speech-Language Pathologist	$0	$2M
Balasubramanyam Krishniah	SC	Internal Medicine Physician	$163.3K	$1.1K
Brad Lindstrom	SC	Primary Podiatric Medicine Podiatrist	$157.6K	$0
Jamelah Lemon	SC	Podiatrist	$140.9K	$0
Dylan Carlisle	SC	Podiatrist	$111.3K	$0
Morgan Cochran	SC	Physical Therapist	$61.6K	$0
Dean Muscarella	SC	Physician Assistant	$37.4K	$0
Sara Borkosky	SC	Foot Surgery Podiatrist	$31.6K	$110

St Francis Physician Services Inc — Billing Profile & Reimbursement Data

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St Francis Physician Services Inc — 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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