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.

Charles Butler (NPI 1881725364)

Field	Value
Entity Type	Individual
Organization	Charles Butler
Address	166 Stoneridge Dr
City	Columbia
State	SC
ZIP	29210
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 8, 2007

Payer Source	Total Paid
Medicare	$3.8M
Medicaid	$0

Key Findings

This provider’s billing is concentrated in Medicare: lifetime Medicare revenue is $3.8M and there is no Medicaid billing on file, so the practice operates effectively as a single-payer (Medicare) revenue stream for the data shown. The absence of Medicaid activity means analyses of in-state Medicaid competitiveness or payer diversification will be limited.

Revenue is highly concentrated in three high-cost oncology drugs: the precomputed top-3 codes account for 65.1% of Medicare revenue, with J9271 generating $928.8K (25.6% of total), J9299 generating $807.3K (22.3% of total), and J9144 generating $622.4K (17.2% of total). This concentration signals that a large share of the provider’s Medicare business derives from administration of biologic/oncology infusions rather than routine primary care or general outpatient procedures.

The service mix and code set indicate an infusion- and oncology-focused operation: frequent billing for J9271, J9299, and J9144 (pembrolizumab, nivolumab, daratumumab) plus supportive oncology drugs (e.g., J0897, J1439) and infusion codes (96413, 96367) together suggest the provider delivers systemic cancer therapies and accompanying supportive care in an office or infusion setting. Imaging and nuclear diagnostic utilization including A9595 ($111.6K) and 78815 ($51.9K) further supports a cancer-care workflow that couples drug administration with advanced diagnostic staging.

Competitive standing by code is mixed: J9299 (rank #49 of 505, 90th percentile) and J9144 (rank #73 of 615, 88th percentile) place the provider in upper-percentile national cohorts for those agents, but the profile descriptions provided label these volumes as "typical, unremarkable" for their respective code populations. By contrast, several non-drug codes are statistical outliers — notably 99214 (1.2K claims, $109.7K; described as an "extreme outlier") and 99213 (1.1K claims, $62.7K; also described as an "extreme outlier") — indicating unusually high office E/M activity relative to national peers.

Multiple procedure codes tied to supportive and procedural care appear above typical peer levels: 96413 (543 claims, $50.5K) is noted as "notably above typical national volume," 96367 (716 claims, $15K) is "notably above typical national volume," and J9217 (576 claims, $74.9K) is characterized as an "extreme outlier." These patterns suggest the practice not only administers high-cost oncology biologics but also bills at elevated rates for chemotherapy administration and certain depot therapies, reinforcing an infusion-centric business model.

Laboratory and imaging lines contribute meaningful secondary revenue: lab panels 80048 ($22.9K) and 80076 ($22.1K) are reported at very high national percentiles (99th and 98th respectively), while diagnostic CT and PET services (74177 $31.8K; A9595 $111.6K) appear in the top-25 revenue list. This mix indicates on-site or referred ancillary services that support ongoing oncology management and patient monitoring.

Tenure is long-standing: the provider’s NPI was enumerated on 2007-03-08 (~19 years ago), which supports interpreting current patterns as the product of an established practice rather than a new entrant. Long enrollment combined with sustained high-volume oncology drug billing suggests an entrenched clinical focus rather than a transient case-mix anomaly.

Payer-concentration risk and competitive implications: with $3.8M in Medicare revenue and no Medicaid revenue on file, the provider’s financial exposure is concentrated in Medicare reimbursement dynamics and oncology drug pricing/coverage. For payer or network analysts, this profile flags a specialist infusion/oncology-oriented operation with strong Medicare dependency and limited leverage from state Medicaid contracts.

Medicare: Complete Services Breakdown

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

81 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	21,600	$40	$928.8K
J9299	Injection, nivolumab, 1 mg	35,100	$20	$807.3K
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	16,380	$40	$622.4K
J0897	Injection, denosumab, 1 mg	12,480	$20	$224.6K
J1449	Injection, eflapegrastim-xnst, 0.1 mg	4,620	$30	$115.5K
A9595	Piflufolastat f-18, diagnostic, 1 millicurie	250	$440	$111.6K
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…	1,220	$90	$109.7K
Q5122	Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg	1,000	$90	$91.6K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	580	$130	$74.9K
J1439	Injection, ferric carboxymaltose, 1 mg	74,250	$1	$74.3K

Showing 1–10 of 81

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 81 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Charles Butler — 9 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. state median

81 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	11	30	19,700	$40	$832K
J9299	2	10	15,760	$20	$432K
J9144	1	10	8,460	$40	$349.4K
A9595	8	10	410	$460	$175.9K
J1449	3	10	4,090	$30	$98.8K
J0897	29	250	2,400	$20	$91.2K
J3490	10	50	70	$510	$57.7K
J2506	11	10	740	$80	$55.9K
Q5122	1	10	540	$90	$55.6K
J1627	2	10	10,400	$1	$46.3K

Showing 1–10 of 81

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Riverside Radiology And Interventional Associates Inc	OH	Diagnostic Radiology Physician	$0	$30.3M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Musc Community Physicians	SC	Internal Medicine Physician	$0	$16.7M
Musc Community Physicians	SC	Family Medicine Physician	$0	$5.6M
Lindsay Gamble	SC	Family Nurse Practitioner	$3.7M	$0
Aaron Flanders	FL	Hematology & Oncology Physician	$3.5M	$0
Jill Sullivan	SC	Internal Medicine Physician	$3.4M	$0
Robert Collins	SC	Internal Medicine Physician	$2.7M	$0
Woodrow Coker	SC	Hospitalist Physician	$2.6M	$0
South Carolina Oncology Assoc PA	SC	Hematology & Oncology Physician	$0	$2.5M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Youth Advocate Program	SC	Community/Behavioral Health Agency	$0	$64M
Lifehme, Inc.	SC	Oxygen Equipment & Supplies (DME)	$0	$45.6M
Pal-med, LLC	SC	Durable Medical Equipment & Medical Supplies	$0	$26.2M
Bright Start, LLC	SC	Speech-Language Pathologist	$0	$20.8M
Kids First Dental, LLC	SC	Dentist	$0	$20.6M
Hospice Care Of South Carolina, Lowcountry, LLC	SC	Community Based Hospice Care Agency	$0	$19.9M
Crescent Hospice, Inc.	SC	Community Based Hospice Care Agency	$0	$17.3M
Coram Healthcare/carolina Home Therapeutics	SC	Home Infusion Therapy Pharmacy	$0	$13.9M
Caring Healthcare, Inc.	SC	Nursing Care Agency	$0	$13.3M
Richland/lexington Disabilities And Special Needs Board	SC	Case Management Agency	$0	$11.3M

Charles Butler — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References