MACDONALD MAYES DUBOSE, M.D.

NPI 1265418164, individual, Sumter, SC, Family Medicine, Geriatric Medicine

Evidence tier

informational

score 30 of 100, rank 11808, $37K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	MACDONALD MAYES DUBOSE, M.D. (also M DUBOSE)
Type	Individual, sole proprietor
Status	Active
NPI issued	December 22, 2005, last updated May 22, 2025
Practice location	244 CHURCH ST, Sumter, SC 29150-4256, 803-775-1001
Specialties	Family Medicine, Geriatric Medicine (207QG0300X, primary, license 22541 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	$101K	90%	$50	$21 (top 5% from $84)	86th percentile
99308	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more	$9K	8%	$33	$14 (top 5% from $58)	86th percentile
99310	Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	$1K	1%	$57	$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	$129	0%	$8.63	$7.86 (top 5% from $34)	too few months to rank
G2010	Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within t	$120	0%	$4.62	$0.98 (top 5% from $33)	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	846	295	$72K	$110	$106	1.0x	2.0x (90th percentile 3.3x)
99215	Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	356	121	$47K	$195	$178	1.1x	2.4x (90th percentile 4.1x)
99306	Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more	154	142	$22K	$180	$180	1.0x	1.9x (90th percentile 3.1x)
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	237	97	$22K	$135	$126	1.1x	2.3x (90th percentile 3.8x)
99308	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more	362	180	$21K	$90	$74	1.2x	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	154	103	$19K	$145	$151	1.0x	2.0x (90th percentile 3.4x)
99454	Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days	338	61	$12K	$60	$45	1.3x	2.6x (90th percentile 4.2x)
99490	Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	186	56	$9K	$65	$62	1.0x	1.8x (90th percentile 2.9x)

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

79 providers in SC carry an indicator in the public record, with $46.1M at stake between them. The most common is part of a provider network, on 39 of them, followed by more hours than a day holds on 31. 4 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	TRANSFORMATION SERVICES Lancaster, SC, ranked 203	$41K	Adjudicated (sentenced, pleaded guilty) per a Department of Justice release dated April 2, 2025. Medicaid paid $41,463 in the last 12 observed months.
1	ACHIEVE BEHAVIORAL HEALTH PA Greenville, SC, ranked 224	$27K	Listed on the Medicare revocation list and the SC Medicaid exclusion list since May 24, 2023. Medicaid still paid claims in 17 later months, $26,595 in total.
1	KEVIN PATEL Charleston, SC, ranked 226	$26K	Listed on the Medicare revocation list since February 18, 2021. Medicaid still paid claims in 8 later months, $25,913 in total.
1	PREMIER MEDICAL, INC. Greenville, SC, ranked 499	$0	Adjudicated (civil judgment) per a Department of Justice release dated July 17, 2025. No Medicaid payments in the last 12 observed months.
2	RYEDENNA SIMON - MCQUEEN Florence, SC, ranked 708	$239K	Billed more hands-on hours than a day holds in 1 month, peaking at 17.8 hours per day across 3 billing organizations. Medicaid dollars per patient on code 90837 ($451 per patient-month) sit in the top 5% of every provider billing that code.
2	KENNETH MARTIN Columbia, SC, ranked 725	$1.9M	Billed more hands-on hours than a day holds in 6 months, peaking at 18.3 hours per day across 3 billing organizations.
3	ROPER ST FRANCIS ANCILLARY SERVICES Ladson, SC, ranked 804	$328K	Part of provider network D1-00115, ranked 115 nationally. Medicaid dollars per patient on code A9900 ($504 per patient-month) sit in the top 5% of every provider billing that code.
3	INSPIRIUM IHC UPSTATE, LLC Greenville, SC, ranked 1077	$794K	Part of provider network D1-00040, ranked 40 nationally.

All 79 in SC

Recent enforcement in SC

All releases

Department 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

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