Physician
Upstate Lung and Critical Care Specialists PC
Upstate Lung and Critical Care Specialists PC was paid $669K by Medicaid between Jan 2018 and Nov 2024, across 16 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 86% of everything it billed.
33Billing provider infoUPSTATE LUNG AND CRITICAL CARE SPECIALISTS PC
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
33aNPI1013963982assigned 05/25/2006
33bProvider typePulmonary Disease Physician
28Total paid$669K
24GClaims21,084
24DCodes billed16
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in South Carolina
Rank by total paid#2 of 25
Median peer was paid$53K
This provider vs. median13×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 3,834 | $94K | |
| 2019 | 3,152 | $88K | |
| 2020 | 2,493 | $82K | |
| 2021 | 2,868 | $98K | |
| 2022 | 3,018 | $111K | |
| 2023 | 2,848 | $104K | |
| 2024incomplete | 2,871 | $91K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 86% | 16,686 | 15,172 | $579K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.0% | 430 | 376 | $20K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.7% | 825 | 683 | $18K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.5% | 250 | 237 | $17K |
| 94010 | 2.4% | 1,441 | 1,376 | $16K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 238 | 99 | $6K |
| 99406 | <1% | 556 | 521 | $3K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 37 | 36 | $2K |
| 94726 | <1% | 124 | 115 | $2K | |
| 94729 | <1% | 122 | 112 | $2K | |
| 94060 | <1% | 122 | 113 | $2K | |
| 31645 | <1% | 27 | 27 | $1K |
4 more codes
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMAYBERRY, LASHANDA (CREDENTIAL COORDINATOR)