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    OpenPayerNPI Medicare & MedicaidWilson Smith
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    Wilson Smith — Billing Profile & Reimbursement Data

    NPI 1982675625 · Spartanburg, SC · Critical Care Medicine (Internal Medicine) Physician

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    Wilson Smith is a critical care medicine (internal medicine) physician provider located in Spartanburg, South Carolina. This profile covers 32 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationWilson Smith
    Address2030 N Church Place
    CitySpartanburg
    StateSC
    ZIP29303
    TaxonomyCritical Care Medicine (Internal Medicine) Physician
    NPI EnumeratedJanuary 31, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$173.7K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    32 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The 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…1,050$60$63.7K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…340$60$20.6K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…90$130$11.8K
    99204The 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…70$110$8.2K
    99214The 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…100$80$7.9K
    94010The 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…440$20$7.9K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…80$90$7K
    90677This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…30$260$7K
    83880The lab analyst measures the amount of natriuretic peptide, a hormone made by heart muscle cells, in the patient specimen. Blood levels of the hormone increase in patients with congestive heart…130$40$4.9K
    95811During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.40$90$3.8K

    Showing 1–10 of 32

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    32 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992144,8217,860160$80$23.2K
    95811376050$230$16.3K
    95810517040$220$14K
    992324142,78090$60$12K
    992131827,690100$60$10.8K
    992338591,77080$90$10.7K
    906946111,05070$80$9.5K
    906775031,23020$280$8.9K
    992234332,08040$130$8.3K
    992041,2204,52040$110$6.4K

    Showing 1–10 of 32

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Spartanburg Medical CenterSCGeneral Acute Care Hospital$0$187.7M
    Axcess Healthcare Services, LLCSCNursing Care Agency$0$98.5M
    South Carolina Dept Of Mental Health Accounting OfficeSCMental Health Clinic/Center (Including Community Mental Health Center)$0$40M
    Spartanburg Medical CenterSCEmergency Medicine Physician$0$17.2M
    Spartanburg Medical CenterSCFamily Medicine Physician$0$17M
    Spartanburg Medical CenterSCMaternal & Fetal Medicine Physician$0$11.5M
    Better Beginnings, IncSCPediatric Occupational Therapist$0$6.9M
    Whitney Road Dental Health Center, P.C.SCGeneral Practice Dentistry$0$6.3M
    Foothills Pediatric Dentistry, PASCPediatric Dentistry$0$4.9M
    Bhg Xxxviii, LLCSCSubstance Use Disorder Rehabilitation Clinic/Center$264.8K$3.5M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. South Carolina Distribution
    Wilson Smith — 3 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina