NPI registry status
Active
2026 NPPES data Pulmonary Disease Physician NPI 1346258746 M.D.
Verify on CMS → Carlton Cauthen, M.D.
Pulmonary Disease Physician in Columbia, South Carolina.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 9,271 in Pulmonary Disease Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
6K
Medicare Part D claims · 815 beneficiaries · Pulmonary Disease Physician avg: 1K
Generic prescribing
0%
generic claims · 56% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
76.8/100
▼ 6 pts below national avg 83.1 · Above neutral
Industry payments
$4.3K
19 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Carlton Cauthen, M.D. reported a CMS MIPS final score of 76.8/100 - below the 83.1 national average - and filed 6,129 Medicare Part D claims in 2023.
- 76.8/100
- MIPS score · -6 vs avg
- 6K
- Part D claims, 2023
- 0%
- generic prescribing
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Carlton Cauthen, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
77 21st percentile higher than 21% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Carlton Cauthen, M.D. sits
This provider among pulmonary disease physician peers
Across the 2,676 pulmonary disease physician providers who report both Medicare Part D prescribing and a MIPS quality score, Carlton Cauthen, M.D. writes more Part D claims than 96% of them and scores higher on MIPS quality than 29% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one pulmonary disease physician peer from a representative sample of 60; the gold marker is Carlton Cauthen, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Carlton Cauthen, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Carlton Cauthen, M.D.?
Below national averagePrimary specialty
Pulmonary Disease Physician
Medicare Part D claims
6,129 321% vs specialty avg
MIPS final score
76.8/100 6.3 pts vs avg
Specialty distribution in South Carolina
How Pulmonary Disease Physician compares to other specialties among South Carolina providers
Medicare quality performance, MIPS
Carlton Cauthen, M.D.'s 2023 MIPS final score plotted against the Pulmonary Disease Physician national average
- MIPS Final Score
- 76.8/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Pulmonary Disease Physician) - 76.8/100 vs national avg 83.1
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Carlton Cauthen, M.D. appears in the CMS NPPES registry as a Pulmonary Disease Physician provider holding M.D. credentials at 3016 LONGTOWN COMMONS DR, Columbia, SC, 29229, with a listed phone of (803) 936-8900. NPI 1346258746 was issued on 08/03/2006.
Medicare Part D records for calendar year 2023 show 6,129 prescription claims written by this provider, covering 815 Medicare beneficiaries and totaling roughly $11.4 million in drug spend, split 56% brand-name and 0% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 76.8/100 for the 2023 performance year (Quality 71.1, Cost 52.6), compared with the national average of 83.1.
Pulmonary Disease Physician is a mid-sized specialty nationwide, with 9,271 enrolled providers across 53 states and an average of 1,457 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline.
Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1346258746 |
|---|---|
| Specialty | Pulmonary Disease Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 08/03/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
76.8466
Final Score
Avg: 83.1
71.0843
Quality
52.571
Cost
99
Promoting Interoperability
Reporting: Group practice
Hospital and facility affiliations
Facilities where Carlton Cauthen, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Musc Community Physicians
Columbia, SC
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Carlton Cauthen, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$4.3K
Largest payer
GENZYME CORPORATION
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Brand vs generic prescribing mix · Brand-heavy
Carlton Cauthen, M.D. - brand share 56.0%
Pulmonary Disease Physician average
56% brand-name claims vs 0% generic, on 6,129 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
6,129
Total Claims
$11.4M
Total Drug Cost
815
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 8,549
- Total Day Supply
- 241,232
- Brand vs Generic
- 56% brand / 0% generic
- Brand Drug Cost
- $10.5M
- Antibiotic Claims
- 143
Patient Demographics
- Average Patient Age
- 72.1 years
- Avg HCC Risk Score
- 1.62
- Gender Split
- 62% female / 38% male
- Age Distribution
- <65: 112, 65-74: 369, 75-84: 274, 85+: 60
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Carlton Cauthen, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Albuterol Sulfate …
Albuterol Sulfate Hfa
820 claims
- Trelegy Ellipta
Trelegy Ellipta
708 claims
- Montelukast Sodium 301
Montelukast Sodium
301 claims
- Breo Ellipta 292
Breo Ellipta
292 claims
- Symbicort 291
Symbicort
291 claims
- Prednisone 284
Prednisone
284 claims
- Tadalafil 271
Tadalafil
271 claims
- Breztri Aerosphere 264
Breztri Aerosphere
264 claims
| Drug | Claims |
|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 820 |
| Trelegy Ellipta Fluticasone/Umeclidin/Vilanter | 708 |
| Montelukast Sodium | 301 |
| Breo Ellipta Fluticasone/Vilanterol | 292 |
| Symbicort Budesonide/Formoterol Fumarate | 291 |
| Prednisone | 284 |
| Tadalafil | 271 |
| Breztri Aerosphere Budesonide/Glycopyr/Formoterol | 264 |
| Spiriva Respimat Tiotropium Bromide | 184 |
| Famotidine | 165 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Pulmonary Disease Physician Overview
How Carlton Cauthen, M.D. fits within the Pulmonary Disease Physician landscape nationally.
9,271
Pulmonary Disease Physician Providers in US
53
States with Pulmonary Disease Physician
1,457
Avg Claims per Provider
Carlton Cauthen, M.D.'s 6,129 claims are above the specialty average of 1,457.
Nearby Pulmonary Disease Physician Providers in South Carolina
Other clinicians with the same primary specialty enrolled in South Carolina, drawn from the same CMS NPPES roster as Cauthen.
Dr. Arun Adlakha
M.D.
Rock Hill, SC
Dr. Ifediora Afulukwe
MD
Heath Springs, SC
Dr. Ramzy Al-Hourany
MD
Florence, SC
Dr. Rober Albertini
MD
Hilton Head, SC
Dr. Gary Anderson
MD
Florence, SC
Compare Pulmonary Disease Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the South Carolina medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Pulmonary Disease Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
What is Carlton Cauthen, M.D.'s specialty? ▼
Carlton Cauthen, M.D. specializes in Pulmonary Disease Physician and practices in Columbia, South Carolina. Credentials: M.D..
How much does Carlton Cauthen, M.D. prescribe under Medicare Part D? ▼
In 2023, Carlton Cauthen, M.D. wrote 6,129 Medicare Part D claims totaling $11.4M in drug costs for 815 beneficiaries.
What is Carlton Cauthen, M.D.'s Medicare quality score? ▼
Carlton Cauthen, M.D. has a CMS MIPS Final Score of 76.8/100 (Quality: 71.1, Cost: 52.6). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Carlton Cauthen, M.D. located? ▼
Carlton Cauthen, M.D. is located at 3016 LONGTOWN COMMONS DR, Columbia, SC, 29229. Phone: (803) 936-8900.
What is Carlton Cauthen, M.D.'s NPI number? ▼
Carlton Cauthen, M.D.'s National Provider Identifier (NPI) is 1346258746, issued on 08/03/2006.
Does Carlton Cauthen, M.D. prescribe more brand-name or generic drugs? ▼
Carlton Cauthen, M.D.'s prescribing is 56% brand-name and 0% generic drugs by claim count, with $10.5M in brand drug costs.
How many Pulmonary Disease Physician providers are there in the US? ▼
There are 9,271 Pulmonary Disease Physician providers across 53 states in the US. The average Pulmonary Disease Physician provider writes 1,457 Medicare Part D claims per year.
What drugs does Carlton Cauthen, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Carlton Cauthen, M.D.'s most frequently prescribed drugs include Albuterol Sulfate Hfa, Trelegy Ellipta, Montelukast Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Carlton Cauthen, M.D. accept Medicare? ▼
Carlton Cauthen, M.D. appears in CMS Medicare data with 6,129 Part D claims and 815 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Carlton Cauthen, M.D.'s credentials? ▼
Carlton Cauthen, M.D.'s NPI is 1346258746 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Compiled from official public sources by the PlainDoctor editorial team.