Providers
KERRY LEWAYNE WHEELER, D.O.
NPI 1164545224, individual, Chapin, SC, General Practice
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 1 month, but with up to 398 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 50 of 100, rank 9652, $44K at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds at a conservative unit price | 7.1 | 37.0 | 24.7 | 33.2 | 398 | 1 | 99306 99307 99308 99309 99310 | $24K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | KERRY LEWAYNE WHEELER, D.O. |
| Type | Individual |
| Status | Active |
| NPI issued | April 6, 2007, last updated March 14, 2016 |
| Practice location | 2101 DUTCH FORK RD, Chapin, SC 29036-7576, 910-742-9243 |
| Mailing address | PO BOX 538622, Atlanta, GA 30353-8622 |
| Specialties | Surgery (208600000X, license SC LL 934 SC) General Practice (208D00000X, primary, license 934 SC) Family Medicine (207Q00000X, license 934 SC) Family Medicine, Geriatric Medicine (207QG0300X, license 934 SC) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $118K | 36% | $44 | $21 (top 5% from $84) | 83rd percentile | |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | $97K | 29% | $86 | $37 (top 5% from $100) | 90th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $76K | 23% | $40 | $14 (top 5% from $58) | 90th percentile | |
| 99356 | Prolonged service inpatient first hour (retired 2023) | $18K | 5% | $43 | $28 (top 5% from $117) | 66th percentile | |
| 99497 | Advance care planning, first 30 minutes | $8K | 2% | $24 | $11 (top 5% from $62) | 69th percentile | |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | $7K | 2% | $59 | $30 (top 5% from $134) | too few months to rank | |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | $3K | 1% | $33 | $7.86 (top 5% from $34) | too few months to rank | |
| 99318 | Medicaid service code | $2K | 0% | $35 | $18 (top 5% from $58) | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 960 | 477 | $72K | $136 | $99 | 1.4x | 2.0x (90th percentile 3.3x) |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 521 | 448 | $70K | $277 | $169 | 1.6x | 1.9x (90th percentile 3.1x) |
| 99497 | Advance care planning, first 30 minutes | 272 | 248 | $16K | $131 | $72 | 1.8x | 2.3x (90th percentile 4.9x) |
| G0317 | Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi | 489 | 151 | $11K | $44 | $29 | 1.5x | 2.3x (90th percentile 4.4x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 237 | 175 | $10K | $102 | $69 | 1.5x | 2.0x (90th percentile 3.4x) |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 36 | 35 | $4K | $194 | $139 | 1.4x | 2.0x (90th percentile 3.4x) |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 19 | 19 | $2K | $198 | $124 | 1.6x | 2.0x (90th percentile 3.3x) |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 14 | 12 | $557 | $75 | $50 | 1.5x | 2.3x (90th percentile 3.8x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
3 providers in Lexington County, SC carry an indicator in the public record, with $3.5M at stake between them. The most common is more hours than a day holds, on 2 of them, followed by part of a provider network on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 2 | KENNETH MARTIN Columbia, SC, ranked 725 | $1.9M |
|
| 3 | LUTHERAN HOMES OF SC, INC. Chapin, SC, ranked 1104 | $666K |
|
| 5 | RICHARD GUYTON Lexington, SC, ranked 11025 | $987K |
Recent enforcement in SC
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedMar 11, 2026
Former Greenville CEO, Employees Indicted in Multi-Million Dollar Health Care Fraud Scheme
The defendants submitted false claims to health care benefit programs for individual COVID-19 tests that had actually been pooled for combined processing and manipulated test processing software, billing for tests that were virtually worthless and ineligible for reimbursement.
DOJSentencedFeb 25, 2026
Lancaster Trio Sentenced for Health Care Fraud Conspiracy
An excluded Medicaid provider and his wife established Transformation Services in her name to bill Medicaid for behavioral health services that were overlapping, not rendered individually, and provided by unlicensed therapists, defrauding Medicaid of nearly $250,000.
DOJIndictedNov 18, 2025
Florida Man Indicted for Health Care Fraud, Wire Fraud in Durable Medical Equipment Scheme
Weinberger, who was excluded from Medicare, allegedly concealed his ownership and control of a Medicare-enrolled durable medical equipment company through a false enrollment document and, with coconspirators, used call centers to generate doctors' orders for orthotic braces and submit approximately $6.7 million in false and fraudulent claims obtained through kickbacks and bribes, medically unnecessary, or otherwise ineligible for reimbursement.
DOJCivil judgmentJul 17, 2025
United States and the States of Georgia, Colorado, and South Carolina Obtain $114.5M in Judgments in a Sprawling Cancer Genetic Testing Lab Scheme
Premier Medical, its owner and compliance vice president paid kickbacks to Freedom Medical Labs and its marketers, who collected DNA samples from Medicaid beneficiaries in public spaces and purchased telemedicine physician orders, to bill Medicaid for medically unnecessary cancer genetic testing.
DOJIndictedJun 30, 2025
S.C. Cases Among Hundreds Announced in National Health Care Fraud Takedown
Two defendants were charged with submitting false claims to Medicare and Medicaid for durable medical equipment that was not delivered or authorized, and with billing the Veterans Administration for massage therapy services not rendered.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.