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.

Walterboro Family Practice Associates, P.A. (NPI 1871532721)

Walterboro Family Practice Associates, P.A. is a family medicine physician provider located in Walterboro, South Carolina. This profile covers 0 Medicare and 10 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	Walterboro Family Practice Associates, P.A.
Address	107 Church St
City	Walterboro
State	SC
ZIP	29488
Taxonomy	Family Medicine Physician
NPI Enumerated	June 6, 2006

Payer Source	Total Paid
Medicaid	$7M
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	100,730	$70	$7M
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…	170	$60	$10K
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.	350	$20	$7K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	20	$50	$1K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	140	$1	$430
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	30	$10	$360
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	20	$20	$350
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.	10	$20	$260
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.	10	$10	$150
90734	The provider administers a meningococcal conjugate vaccine in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM) to protect the patient from four strains of meningococcal viruses…	10	$0	$0

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

Walterboro Family Practice Associates, P.A. — 1 of 9 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	16	350	3,560	$30	$525.5K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	136	180	1,360	$20	$152.1K
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.	614	650	140	$30	$98.1K
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…	88	140	270	$60	$89.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	216	240	280	$50	$78.4K
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.	268	540	350	$20	$52K
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.	490	540	240	$10	$35.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	251	320	60	$1	$2.4K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	402	590	60	$1	$790
90734	The provider administers a meningococcal conjugate vaccine in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM) to protect the patient from four strains of meningococcal viruses…	157	170	80	$1	$80

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Colleton County Board Of Disabilities And Special Needs	SC	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$16.7M
Walterboro Community Hospital, Inc.	SC	General Acute Care Hospital	$0	$11.8M
Colleton County School District	SC	Speech-Language Pathologist	$0	$3.1M
Walterboro Adult & Pediatric Medicine, LLC	SC	Rural Health Clinic/Center	$0	$2.2M
Genesis Health Care, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$2.1M
County Of Colleton	SC	Ambulance	$518.9K	$1.5M
Genesis Healthcare, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$1.9M
Beacon Respiratory Services Of Georgia, Inc	SC	Oxygen Equipment & Supplies (DME)	$0	$1.7M
Med-trans Corporation	SC	Air Ambulance	$544K	$0
Vlastimil Smetka	SC	Family Medicine Physician	$457.3K	$0

Walterboro Family Practice Associates, P.A. — Billing Profile & Reimbursement Data

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Walterboro Family Practice Associates, 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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Frequently Asked Questions

References