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.

Mcleod Loris Seacoast Hospital (NPI 1306123344)

Field	Value
Entity Type	Organization
Organization	Mcleod Loris Seacoast Hospital
Address	3655 Mitchell St
City	Loris
State	SC
ZIP	29569
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 4, 2011

Payer Source	Total Paid
Medicaid	$24.8M
Medicare	$0

Key Findings

MCLEOD LORIS SEACOAST HOSPITAL appears effectively single‑payer in the available data: there is no Medicare billing on file and the provider reports $24.8M in lifetime Medicaid revenue. The entity's NPI was enumerated on 2011-11-04 (~15 years ago), indicating more than a decade of billing history under the current identifier.

Revenue concentration is high within Medicaid: the precomputed top three Medicaid codes account for 46.9% of the provider's total Medicaid revenue. Those top three codes are 36415 ($3.8M, 18.2%), 99283 ($3.3M, 15.9%), and 97110 ($2.6M, 12.8%), showing that a small set of services drives nearly half of Medicaid receipts.

Service-line mix is weighted toward emergency department throughput and high-volume specimen collection: 99283 (54.1K claims, $3.3M, 15.9%) and 99284 (36.4K claims, $1.5M, 7.0%) together reflect large volumes of low-to-moderate acuity ED visits, while 36415 (53.9K claims, $3.8M, 18.2%) is the single largest revenue code by share, consistent with heavy phlebotomy/lab specimen activity supporting ED and inpatient operations.

The provider shows substantial outpatient rehabilitation and therapy activity: 97110 (50K claims, $2.6M, 12.8%) ranks #8 of 285 in-state (98th percentile; notably above typical state volume), and related CPTs such as 97112 (11.1K claims, $321K, 1.5%) rank #2 of 54 in-state (98th percentile). This mix indicates a meaningful PT/rehab service line contributing materially to Medicaid revenue alongside ED and lab services.

Several codes are state-level statistical outliers or high-percentile performers, indicating competitive strength in specific service lines: 36415 ranks #11 of 713 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), 99283 ranks #13 of 341 (96th percentile; notably above typical state volume), and 97110 ranks #8 of 285 (98th percentile; notably above typical state volume). These ranks signal that the hospital is a major in-state provider for phlebotomy, ED E/M at lower acuity, and therapeutic exercise.

The provider also maintains broad ancillary and diagnostic capacity beyond ED and PT: contrast material Q9967 ($1.6M, 7.9%) and infusion supply J7030 ($400.9K, 1.9%) appear in the top code set, and imaging contrast A9585 ($314.9K, 1.5%) is present as well. Combined with frequent lab testing (87635, 87651, U0003) and point-of-care testing (81001, 81025), the pattern is consistent with an acute-care hospital offering integrated lab, imaging, infusion, and rehab services.

The Medicaid code mix suggests the hospital's revenue is volume‑sensitive and concentrated in throughput-dependent services: heavy reliance on phlebotomy, lower-complexity ED visits, and therapeutic exercise (the three top codes at 46.9%) implies operational exposure to changes in Medicaid utilization patterns or reimbursement policy for these procedure types. This concentration presents both operational risk and potential levers for margin improvement via efficiency or care-pathway redesign.

While the hospital posts high in-state ranks for several codes, its absence of Medicare billing means its competitive footprint is learned only from Medicaid activity; the provider is a significant, often top‑tier player in multiple Medicaid-coded services within South Carolina but has no analogous Medicare presence in the supplied data. Analysts should treat observed strengths as state-market dominance in specific service lines rather than as evidence of cross-payer scale.

Medicaid: Complete Services Breakdown

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

252 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	53,880	$70	$3.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	54,140	$60	$3.3M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	49,950	$50	$2.6M
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	9,370	$180	$1.6M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	36,410	$40	$1.5M
0241U	N/A	9,060	$110	$997K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	8,190	$100	$843.6K
99281	The provider sees a patient for the lowest level emergency department visit.	4,230	$130	$537.3K
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…	14,260	$40	$527.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	6,360	$80	$521.8K

Showing 1–10 of 252

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

Mcleod Loris Seacoast Hospital — 7 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

252 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	81	340	2,970	$80	$711.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	37	210	1,470	$60	$615K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	30	350	2,590	$70	$550.2K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	13	340	110	$40	$450.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	17	350	100	$50	$446.9K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	39	200	1,680	$50	$443.2K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	36	60	170	$430	$434.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	26	140	2,520	$90	$415.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	8	290	2,600	$60	$414.4K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	14	110	1,880	$100	$414K

Showing 1–10 of 252

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mcleod Loris Seacoast Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Jackson	SC	Cardiovascular Disease Physician	$635.8K	$0
Gavin Leask	SC	Cardiovascular Disease Physician	$532.2K	$0
Neerav Sheth	PA	Interventional Cardiology Physician	$525.9K	$0
Amit Pande	SC	Cardiovascular Disease Physician	$504.5K	$0
Nathan Almeida	SC	Cardiovascular Disease Physician	$488.2K	$0
Vinod Jona	SC	Pulmonary Disease Physician	$482.5K	$0
Alexander Bustamante	VA	Cardiovascular Disease Physician	$476K	$0
Anne Everman	SC	Cardiovascular Disease Physician	$446.7K	$0
David Budhoo	SC	Internal Medicine Physician	$362.7K	$0
Yama Osmanzai	SC	Infectious Disease Physician	$348.8K	$0

Nearby Providers

Other providers in the same ZIP code as Mcleod Loris Seacoast Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seashore Pediatrics	SC	Pediatrics Physician	$0	$15.8M
Little River Medical Center, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$3.6M
Timothy Mills	SC	Family Medicine Physician	$257.8K	$0
Ashley Wilson	SC	Physician Assistant	$218.5K	$0
Tracy Ray	SC	Optometrist	$122.7K	$11.7K
Melissa Miara	SC	Pulmonary Disease Physician	$128.1K	$0
Brian Thacker	SC	Family Medicine Physician	$125.2K	$0
Leonard Schwartz	SC	Internal Medicine Physician	$100K	$0
Susan Stuber	SC	Anatomic Pathology & Clinical Pathology Physician	$75.1K	$0
Carla Hamilton	SC	Certified Registered Nurse Anesthetist	$47.6K	$0

Mcleod Loris Seacoast Hospital — Billing Profile & Reimbursement Data

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Mcleod Loris Seacoast Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References