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.

Allergic Disease And Asthma Center PA (NPI 1952302853)

Allergic Disease And Asthma Center PA is a allergy physician provider located in Greenville, South Carolina. This profile covers 0 Medicare and 16 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	Allergic Disease And Asthma Center PA
Address	1202 E Butler Rd
City	Greenville
State	SC
ZIP	29607
Taxonomy	Allergy Physician
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

16 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…	7,450	$70	$543.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2,330	$160	$375.1K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1,330	$220	$295.9K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	23,050	$10	$161.3K
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…	3,270	$50	$156.9K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	5,420	$20	$113.9K
99204	The provider sees a new 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 provider…	680	$120	$78.5K
95115	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives a single injection during the visit.	8,870	$10	$53.2K
89190	The analyst performs an examination of a nasal smear to check for the presence of eosinophils, which are a type of white blood cell that increases in number in response to allergies and parasitic…	4,880	$1	$19.5K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	90	$140	$12.7K

Showing 1–10 of 16

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

Allergic Disease And Asthma Center PA — 2 of 15 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	13	40	120	$220	$367.6K
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…	488	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	619	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…	206	2,480	350	$80	$246K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	9	30	860	$130	$203.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	63	110	70	$150	$157.3K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	7	10	140	$130	$87.2K
99204	The provider sees a new 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 provider…	81	490	90	$100	$63.6K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	4	90	140	$50	$58.5K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	25	40	130	$150	$53.9K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emmanuel Sarmiento	SC	Allergy Physician	$161.3K	$9.2K
Neil Kao	SC	Allergy Physician	$128.6K	$4.6K
Angelina Lombardi	SC	Allergy Physician	$32.6K	$1.1K
Candace Cothran	SC	Allergy Physician	$24.3K	$100
Leigh Paxton	OR	Physician Assistant	$6.7K	$0
Maci Lindquist	SC	Physician Assistant	$5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health University Medical Group	SC	Family Medicine Physician	$0	$171.7M
Greenville County Disabilities And Special Needs Board	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$51.7M
Heart Of The Carolinas Medical Supply, LLC	SC	Nursing Care Agency	$0	$36.4M
Caris Healthcare LLC	SC	Community Based Hospice Care Agency	$0	$36.3M
Greenville County Commission On Alcohol And Drug Abuse	SC	Substance Use Disorder Rehabilitation Clinic/Center	$0	$12.7M
St. Francis Hospital Inc	SC	General Acute Care Hospital	$0	$9M
Tribe513, P.A.	SC	Pediatric Adolescent Medicine Physician	$0	$8.6M
Luxor Scientific, LLC	SC	Clinical Medical Laboratory	$2.2M	$5.6M
Pleasantburg Drive Dental Health Center, P.C.	SC	General Practice Dentistry	$0	$6.5M
Inspirium Ihc Upstate, LLC	SC	Home Health Agency	$0	$6.4M

Allergic Disease And Asthma Center PA — Billing Profile & Reimbursement Data

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Allergic Disease And Asthma Center PA — 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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