Providers

RICHARD KYLE GUYTON, M.D.

NPI 1457483893, individual, Lexington, SC, Pediatrics

5
Evidence tier
informational
score 31 of 100, rank 11025, $987K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameRICHARD KYLE GUYTON, M.D.
TypeIndividual
StatusActive
NPI issuedMarch 12, 2007, last updated August 15, 2019
Practice location424 OLD CHEROKEE RD, Lexington, SC 29072-6972, 803-520-5800
Mailing address448 OLD CHEROKEE RD, Lexington, SC 29072-9031
Specialties
Pediatrics (208000000X, primary, license 27216 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$1.5M26%$73$44 (top 5% from $110)84th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$1.3M22%$103$60 (top 5% from $133)87th percentile
90460Administration of first vaccine or toxoid component with counseling (18 years or younger)$519K9%$52$26 (top 5% from $54)94th percentile
99392Medicaid service code$495K9%$102$78 (top 5% from $124)84th percentile
99391Medicaid service code$409K7%$97$76 (top 5% from $126)80th percentile
99393Medicaid service code$375K7%$102$78 (top 5% from $121)85th percentile
99394Medicaid service code$212K4%$111$83 (top 5% from $128)86th percentile
G9153Medicaid service code$161K3%$48$49 (top 5% from $68)47th percentile

In this area

3 providers in Lexington County, SC carry an indicator in the public record, with $2.6M 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.

tierproviderat stakewhy
2KENNETH 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.
3LUTHERAN HOMES OF SC, INC.
Chapin, SC, ranked 1104
$666K
  • Part of provider network D1-00104, ranked 104 nationally.
4KERRY WHEELER
Chapin, SC, ranked 9652
$44K
  • 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.

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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