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.

Kalpesh Purohit (NPI 1942426093)

Field	Value
Entity Type	Individual
Organization	Kalpesh Purohit
Address	100 Palmetto Health Pkwy Ste 104
City	Columbia
State	SC
ZIP	29212
Taxonomy	Family Medicine Physician
NPI Enumerated	April 17, 2007

Payer Source	Total Paid
Medicare	$2.1M
Medicaid	$0

Key Findings

This provider’s billing is effectively single-payer Medicare: lifetime Medicare revenue is $2.1M while Medicaid revenue is listed as none (no Medicaid billing on file). The precomputed concentration metric shows the top three Medicare codes account for 95.9% of Medicare revenue, indicating the business is strongly Medicare-dependent rather than diversified across payers.

Revenue is highly concentrated in a single supply code: Q4236 accounts for $1.9M or 90.1% of the provider’s Medicare revenue, with 1.9K claims and an average paid per claim of $1016. That level of concentration means reimbursement or coverage changes for Q4236 would have outsized impact on this provider’s topline.

The code mix points to a wound-care and skilled-nursing facility operational model: dominant Q4236 (Carepatch, per square centimeter) plus procedure codes for debridement (11043, 11042, 11044), skin substitute use (15271), and wound excision (97597) indicate active procedural wound management. At the same time, an array of nursing facility E/M codes (99304–99310 series) — including 99308 and 99309 — suggests regular onsite visits to long‑term care or SNF residents rather than a typical office-based primary care panel.

Benchmarking of the top revenue codes shows the provider is not a national leader nor an outlier. Q4236 ranks #35 of 79 providers nationally (56th percentile; typical, unremarkable volume for this code), while the nursing-facility E/M codes appear at ranks such as #2479 of 25763 (99308; 90th percentile; typical, unremarkable volume for this code) and #5033 of 28092 (99309; 82th percentile; typical, unremarkable volume for this code), reflecting respectable activity but not dominant market share.

Claim-level patterns reinforce a high-frequency, high-value supply strategy: 1.9K claims for Q4236 at $1016 avg paid/claim drive the majority of revenue, complemented by 1.1K claims for 99308 ($57 avg paid/claim) and 735 claims for 99309 ($82 avg paid/claim). This combination of high unit price for the supply code and steady volume for nursing-facility E/M visits is consistent with a business model that pairs costly wound-care supplies with routine facility-based evaluation services.

Despite the revenue concentration, benchmarking labels indicate no statistical outliers in utilization: most listed codes are described as having "typical, unremarkable volume for this code." That suggests the provider’s pattern is concentrated but generally falls within expected national utilization ranges rather than showing anomalous billing behavior in published benchmarks.

The provider has an established billing history, with NPI enumerated 2007-04-17 (~19 years ago), which supports that these patterns are likely stable and not the result of a recent practice change. Longevity may also signal an embedded relationship with local SNFs or wound-care referral streams that sustain the concentrated Medicare revenue.

From a payer or network perspective, the absence of Medicaid billing (none (no Medicaid billing on file)) limits the provider’s exposure to state Medicaid populations and suggests opportunities or gaps for managed Medicaid networks seeking wound-care capacity. For payers evaluating contracting or utilization management, the key priorities would be monitoring Q4236 utilization and contract terms for high-dollar supply billing while assessing quality and outcomes tied to the nursing-facility E/M and wound-procedure services.

Medicare: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4236	Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)	1,900	$1,020	$1.9M
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	1,120	$60	$63.7K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	740	$80	$60.3K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	150	$140	$20.4K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	130	$120	$15.2K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	140	$100	$14K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	90	$110	$10.1K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	70	$140	$9.9K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	160	$60	$9.1K
11044	The provider uses surgical instruments to remove the dead, infected tissue in bone, also including the epidermis, dermis, subcutaneous tissue, muscle, and/or fascia as needed. This code covers the…	20	$170	$3.1K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Kalpesh Purohit — 1 of 14 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

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4236	1	10	1,900	$1,020	$1.9M
99309	92	470	290	$70	$29.9K
11043	7	30	60	$130	$18.2K
99310	92	270	80	$100	$17.2K
99306	69	160	60	$130	$15K
99308	16	390	120	$50	$12.9K
11044	10	10	30	$170	$9.4K
11042	50	170	70	$60	$8.4K
15271	6	20	60	$80	$6.9K
99305	11	120	40	$100	$6.8K

Showing 1–10 of 14

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Self Regional Healthcare	SC	General Acute Care Hospital	$0	$58.8M
Doctors Care, PA	SC	Family Medicine Physician	$0	$50.7M
Medcare Express - North Charleston LLC	SC	Urgent Care Clinic/Center	$0	$34.8M
Vohra Post Acute Care Physicians Of The East, PA	FL	Family Medicine Physician	$0	$10.6M
Self Medical Group	SC	Emergency Medicine Physician	$0	$6M
Steven Madden	SC	Hematology & Oncology Physician	$4M	$0
Stephen Parks	SC	Family Medicine Physician	$3.9M	$0
St Francis Physician Services Inc	SC	Family Medicine Physician	$0	$3.3M
Self Medical Group	SC	Pediatrics Physician	$0	$3.3M
Self Medical Group	SC	Urgent Care Clinic/Center	$0	$2.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Options, Inc.	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$40.2M
Prisma Health-midlands	SC	General Acute Care Hospital	$0	$4.3M
Prisma Health-midlands	SC	General Acute Care Hospital	$0	$3.1M
School District 5 Of Lexington & Richland Counties	SC	Local Education Agency (LEA)	$0	$2.8M
Prisma Health Medical Group-midlands	SC	Interventional Cardiology Physician	$0	$2.5M
Irmo Kids Dental LLC	SC	Dental Clinic/Center	$0	$1.8M
Play 2 Learn Early Intervention	SC	Early Intervention Provider Agency	$0	$1.7M
Counseling For Hope & Healing	SC	Professional Counselor	$0	$1.6M
Lexington Health Inc	SC	Ambulatory Surgical Clinic/Center	$792.7K	$22.3K
Lexington Health Inc	SC	Radiology Clinic/Center	$599.2K	$34.3K

Kalpesh Purohit — Billing Profile & Reimbursement Data

Sign up for Kalpesh Purohit — Billing Profile & Reimbursement Data policy alerts

Kalpesh Purohit — Billing Profile & Reimbursement Data

Sign up for Kalpesh Purohit — Billing Profile & Reimbursement Data policy alerts

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