VERITY
Providers

VLASTIMIL SMETKA, MD

NPI 1497974273, individual, Walterboro, SC, Family Medicine

5
Evidence tier
informational
score 31 of 100, rank 11306, $364K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameVLASTIMIL SMETKA, MD
TypeIndividual
StatusActive
NPI issuedApril 24, 2007, last updated April 9, 2026
Practice location501 ROBERTSON BLVD, Walterboro, SC 29488-2787, 843-782-2737
Specialties
Family Medicine (207Q00000X, license ME142327 FL)
Family Medicine (207Q00000X, license 4301515425 MI)
Family Medicine (207Q00000X, license 71464 MN)
Family Medicine (207Q00000X, primary, license 29413 SC)
Family Medicine (207Q00000X, license 01095551A IN)
Family Medicine (207Q00000X, license 2014-01499 NC)
Family Medicine (207Q00000X, license LL29413 SC)
Family Medicine (207Q00000X, license MD472500 PA)
Family Medicine (207Q00000X, license 85033 GA)
Family Medicine (207Q00000X, license 33875 WV)
Family Medicine (207Q00000X, license D0100667 MD)
Family Medicine (207Q00000X, license 1024552 MA)
Family Medicine (207Q00000X, license MD20513 RI)
Family Medicine (207Q00000X, license 343143 NY)
Family Medicine (207Q00000X, license 0101280117 VA)

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
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$436K64%$45$21 (top 5% from $84)84th percentile
99306Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more$99K15%$84$37 (top 5% from $100)90th percentile
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes$81K12%$59$22 (top 5% from $71)92nd percentile
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes$42K6%$63$30 (top 5% from $134)81st percentile
99318Medicaid service code$10K2%$33$18 (top 5% from $58)80th percentile
99490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month$7K1%$9.93$6.11 (top 5% from $38)67th percentile
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$2K0%$141$67 (top 5% from $174)too few months to rank
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more$3730%$31$14 (top 5% from $58)too few months to rank
Medicare Part B 2024, largest codes
codewhat it isservicesbeneficiariespaidsubmitted per serviceallowed per servicecharge to allowedusual for this code
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes2,9781,360$224K$164$1011.6x2.0x (90th percentile 3.3x)
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes841764$81K$188$1251.5x2.0x (90th percentile 3.3x)
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes110100$10K$202$1211.7x2.0x (90th percentile 3.4x)
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more9684$5K$119$701.7x2.0x (90th percentile 3.4x)
99307Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes2725$781$76$382.0x2.4x (90th percentile 4.1x)

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 $45.8M 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.

tierproviderat stakewhy
1TRANSFORMATION 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.
1ACHIEVE 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.
1KEVIN 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.
1PREMIER 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.
2RYEDENNA 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.
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.
3ROPER 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.
3INSPIRIUM 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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