Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Carolina only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Carolina (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Lexington County Health Services District, Inc. (NPI 1255359725)

Field	Value
Entity Type	Organization
Organization	Lexington County Health Services District, Inc.
Address	222 East Medical Lane, Ste 300
City	West Columbia
State	SC
ZIP	29169
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	July 17, 2006

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	33,790	$50	$1.8M
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	1,070	$110	$114.7K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	1,230	$70	$89.7K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	1,490	$60	$86.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	910	$80	$70.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,970	$30	$65K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	580	$70	$39.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	300	$80	$23.7K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	250	$90	$21.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	10,100	$1	$20.2K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Carolina Distribution

Lexington County Health Services District, Inc. — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	54	60	50	$960	$381.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	65	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	69	710	350	$60	$247.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,282	2,480	350	$80	$246K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	25	100	240	$100	$187.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	16	70	150	$70	$156.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	284	410	330	$50	$152.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	88	610	190	$50	$98.4K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	189	380	660	$30	$90K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	347	520	70	$70	$67.1K

Showing 1–10 of 28

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lexington County Health Services District, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lexington County Health Serv	SC	General Acute Care Hospital	$0	$4M
Steven Madden	SC	Hematology & Oncology Physician	$4M	$0
Asheesh Lal	SC	Hematology & Oncology Physician	$3.2M	$0
James Wells	SC	Hematology & Oncology Physician	$3.2M	$0
Joel Waldrop	SC	Emergency Medicine Physician	$2.4M	$9.3K
Andrew Donato	SC	Emergency Medicine Physician	$2.3M	$8.9K
Lexington County Health Services District, Inc.	SC	Urgent Care Clinic/Center	$0	$1.6M
Christina Smith	SC	Family Nurse Practitioner	$1.5M	$0
Bruce Goeckeritz	SC	Internal Medicine Physician	$1.3M	$0
Amy Epps	SC	Cardiovascular Disease Physician	$632.5K	$0

Nearby Providers

Other providers in the same ZIP code as Lexington County Health Services District, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Palmetto Infusion Services LLC	SC	Infusion Therapy Clinic/Center	$0	$93.6M
Lexington Health Inc	SC	General Acute Care Hospital	$0	$27.4M
Lexington County Health Services District Inc	SC	General Acute Care Hospital	$0	$19.2M
United Cerebral Palsy Of South Carolina, Inc	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$15.7M
Palmetto Retina Center LLC	SC	Ophthalmology Physician	$0	$10.6M
Lexington Health Inc	SC	Emergency Medicine Physician	$0	$4.2M
Karen Park Family Dentistry, P.A.	SC	Dentist	$0	$4.2M
John Payne	SC	Ophthalmology Physician	$4M	$0
John Wells	SC	Ophthalmology Physician	$3.9M	$0
Lexington Treatment Specialists LLC	SC	Methadone Clinic	$76.7K	$3.6M

Lexington County Health Services District, Inc. — Billing Profile & Reimbursement Data

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Lexington County Health Services District, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References