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.

University Medical Associates Of The Medical University Of South Carol (NPI 1982678496)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Medical Associates Of The Medical University Of South Carol
Address	171 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	Family Medicine Physician
NPI Enumerated	February 14, 2006

Payer Source	Total Paid
Medicaid	$56.6M
Medicare	$0

This provider is effectively single‑payer in the available claims data: there is no Medicare billing on file while Medicaid revenue totals $56.6M, indicating that Medicaid drives the entirety of reported public-payer receipts for this NPI. The absence of Medicare activity concentrates revenue and payer risk on Medicaid payment policy and utilization patterns in the state.

Revenue concentration is high across a small set of Medicaid codes: the top three Medicaid codes (99469, 99214, 99472) together account for 41.2% of the provider's total Medicaid revenue. Individually those codes generate $8.8M (99469, 16.3%), $8M (99214, 14.8%), and $5.5M (99472, 10.2%), showing a reliance on a few high‑value service lines for a large share of receipts.

Clinical mix is heavily skewed toward neonatal and infant critical care alongside routine outpatient evaluation and management. Codes 99469 and 99472 (neonatal critical care/subsequent inpatient care of critically ill infants) are top revenue drivers and 99479/99480 (recovering low birth weight infant care) also appear in the top list, which together indicate substantive NICU and infant follow‑up capacity rather than only adult primary care services.

At the same time, this NPI reports extremely large outpatient E/M volumes: 99214 appears with 103.9K claims and $8M revenue and is labeled an extreme outlier statewide (rank #6 of 2483, 100th percentile), while 99213 (77.1K claims, $3.3M) is also an extreme outlier (rank #18 of 2766, 99th percentile). These figures point to a significant primary care or outpatient clinic footprint in parallel with the neonatal/inpatient work.

The provider is a major in‑state competitor for inpatient consultation, high‑complexity inpatient visits, and consultation codes: 99233 (subsequent inpatient care) is an extreme outlier (rank #1 of 115, 100th percentile), 99244 and 99245 (outpatient consultations) are extreme outliers or top statewide performers (99244 rank #2 of 110, 99th percentile; 99245 rank #1 of 26, 100th percentile), and 99254 is rank #1 of 19 (100th percentile). This mix suggests the practice performs substantial hospital‑based and consultative work in addition to outpatient visits.

ED and urgent care level E/M codes appear throughout the top list (99284, 99283, 99282, 99285) alongside higher‑level office visit codes (99215), signaling a broad scope that includes emergency department throughput as well as extended outpatient encounters. Several of these codes are high percentile performers in‑state (for example 99284 at the 93rd percentile and 99285 at the 77th percentile), which supports a multi‑setting service model rather than a narrow clinic practice.

Cardiac imaging for congenital or complex pediatric patients is a notable ancillary service line: 93303 (complete transthoracic echo for congenital heart defects) is high volume and ranks #1 of 10 (100th percentile), 93320 ranks #1 of 13 (100th percentile), and 93306 is high (97th percentile). The prominence and ranks of these echocardiography codes indicate integrated diagnostic imaging capacity that aligns with the neonatal/infant care activity in the top codes.

The provider has an established market presence—its NPI was enumerated on 2006-02-14 (~20 years ago)—which is consistent with the high claim volumes and frequent top‑rank placements across many Medicaid codes. That tenure, combined with dominant statewide rankings on multiple high‑revenue codes, suggests this entity is a long‑standing, major Medicaid provider in its service areas, but the heavy concentration of revenue in a few codes (top three = 41.2%) also implies exposure to changes in those specific Medicaid reimbursements or utilization patterns.

Medicaid: Complete Services Breakdown

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

139 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	21,540	$410	$8.8M
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…	103,870	$80	$8M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	13,460	$410	$5.5M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	30,770	$110	$3.5M
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…	20,870	$160	$3.3M
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…	77,080	$40	$3.3M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	23,130	$130	$3M
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…	25,950	$110	$2.8M
99233	The 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…	28,400	$100	$2.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	40,750	$60	$2.5M

Showing 1–10 of 139

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

University Medical Associates Of The Medical University Of South Carol — 16 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. South Carolina median

139 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1	10	70	$410	$2.2M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	150	$410	$1.4M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	1	10	450	$130	$533.6K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1	10	120	$100	$502.6K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	23	340	110	$40	$450.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	26	350	100	$50	$446.9K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	46	200	1,680	$50	$443.2K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	10	20	380	$520	$421.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	44	140	2,520	$90	$415.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	174	280	600	$90	$299K

Showing 1–10 of 139

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$241.1M
Medical University Hospital Authority	SC	Psychologist	$0	$32.6M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$28.3M
Musc Community Physicians	SC	Internal Medicine Physician	$0	$16.7M
Providence Hospital, LLC	SC	General Acute Care Hospital	$0	$12.7M
Medical University Hospital Authority	SC	Pediatrics Physician	$0	$12.4M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$12.1M
University Medical Associates	SC	Pediatrics Physician	$0	$9.2M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$8.7M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$8.5M

University Medical Associates Of The Medical University Of South Carol — Billing Profile & Reimbursement Data

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University Medical Associates Of The Medical University Of South Carol — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Musc Affiliate Physicians	SC	Family Medicine Physician	$0	$14.7M
University Medical Associates Of The Medical University Of South Carol	SC	Obstetrics & Gynecology Physician	$0	$6.1M
University Medical Associates Of The Medical University Of South Carol	SC	Diagnostic Radiology Physician	$0	$5.4M
University Medical Associates Of The Medical University Of South Carol	SC	Emergency Medicine Physician	$0	$3.6M
University Medical Associates Of The Medical University Of South Carol	SC	Pediatrics Physician	$0	$3.5M
University Medical Associates Of The Medical University Of South Carol	SC	Psychiatry Physician	$0	$3.3M
Rosalee Unwin	SC	Family Nurse Practitioner	$2.9M	$0
Jennifer Douglas	SC	Physician Assistant	$2.9M	$0
University Medical Associates Of The Medical University Of South Carol	SC	Multi-Specialty Clinic/Center	$0	$2.8M
Woodrow Coker	SC	Hospitalist Physician	$2.6M	$0