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.

William James (NPI 1952356602)

Field	Value
Entity Type	Individual
Organization	William James
Address	475 Heywood Ave
City	Spartanburg
State	SC
ZIP	29307
Taxonomy	Obstetrics Physician
NPI Enumerated	May 23, 2006

Payer Source	Total Paid
Medicare	$57.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	350	$120	$41K
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	180	$40	$6.8K
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…	60	$90	$5.2K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	70	$40	$2.9K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	20	$70	$1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	20	$10	$140
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	40	$1	$80

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

William James — 2 of 7 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

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	5,718	7,860	160	$80	$23.2K
99215	81	2,360	40	$120	$9.3K
36415	1,942	2,090	140	$10	$2.7K
G0101	7	310	30	$40	$1.6K
Q0091	23	150	20	$40	$1.6K
76856	38	60	20	$50	$1.1K
81003	816	1,870	40	$1	$200

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Charles Lea Center Inc.	SC	In Home Supportive Care Agency	$0	$70.3M
Spartanburg School District 7	SC	Local Education Agency (LEA)	$0	$9.2M
Elite Home Care	SC	In Home Supportive Care Agency	$0	$6.9M
Spartanburg Medical Center	SC	Urgent Care Clinic/Center	$0	$4.2M
Spartanburg Medical Center	SC	Obstetrics & Gynecology Physician	$0	$3.3M
Circle Of Angels Home Health Care	SC	Home Health Agency	$0	$3M
Spartanburg Pediatric Dentistry	SC	Pediatric Dentistry	$0	$2.7M
Mary Black Health System LLC	SC	General Acute Care Hospital	$0	$2.3M
Allergy Partners, PLLC	SC	Allergy & Immunology Physician	$0	$2.2M
Lincare Inc.	SC	Durable Medical Equipment & Medical Supplies	$0	$2M

William James — Billing Profile & Reimbursement Data

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William James — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References