Palmetto Health

Palmetto Health was paid $93K by Medicaid between Jan 2018 and Apr 2018, across 14 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 22% of everything it billed.

33Billing provider infoPALMETTO HEALTH
COLUMBIA, SC 29203

33aNPI1912242876assigned 12/04/2012

33bProvider typeOphthalmology Physician

28Total paid$93K

24GClaims1,640

24DCodes billed14

24AFirst – last monthJan 2018 – Apr 2018

Compared with peers

Next to other Ophthalmology Physician providers in South Carolina

Rank by total paid#18 of 64

Median peer was paid$15K

This provider vs. median6.1×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official COVEN, DARRELL controls 12+ related entities in our dataset. Read more

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	1,640	$93K

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	22%	278	277	$21K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	14%	246	241	$13K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	13%	166	159	$12K
92015	Determination of refractive state	11%	400	382	$10K
99243		9.1%	89	84	$8K
99244	Office or other outpatient consultation, moderate to high complexity	8.7%	55	53	$8K
92083		6.4%	113	110	$6K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	5.4%	55	51	$5K
92060		3.4%	74	72	$3K
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	2.8%	28	28	$3K
92133		1.9%	71	67	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.4%	30	28	$1K

2 more codes

92002		1.3%	22	$1K
92340	Fitting of spectacles, except for aphakia; monofocal	<1%	13	$214.50

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 officialCOVEN, DARRELL (DIRECTOR-AMBULATORY SRVCS-FINANCE)

Parent organizationPALMETTO HEALTH

Same official

Other billing entities under COVEN, DARRELL

Full network →

Provider	Location	Paid
Palmetto Health	Sumter, SC	$597K
Palmetto Health	Columbia, SC	$154K
Palmetto Health	Columbia, SC	$114K
Palmetto Health	Columbia, SC	$80K
Palmetto Health	Columbia, SC	$15K
Palmetto Health	Columbia, SC	$10K
Palmetto Health	Columbia, SC	$5K
Palmetto Health	Columbia, SC	$4K
Palmetto Health	Columbia, SC	$4K
Palmetto Health	Columbia, SC	$3K
Palmetto Health	Columbia, SC	$1K
Palmetto Health	Columbia, SC	$708.59

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.