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.

St. James Health And Wellness Inc. (NPI 1316345846)

Field	Value
Entity Type	Organization
Organization	St. James Health And Wellness Inc.
Address	57 Jessamine Ave
City	Georgetown
State	SC
ZIP	29440
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	December 16, 2014

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

52 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…	22,250	$140	$3M
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…	3,410	$130	$453.3K
T1015	Clinic visit/encounter, all-inclusive	3,270	$130	$412.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,740	$140	$381.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,430	$140	$342.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,440	$140	$199.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,070	$140	$145K
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,…	690	$150	$103.4K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	2,650	$20	$63.6K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	6,140	$10	$55.3K

Showing 1–10 of 52

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

St. James Health And Wellness 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

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	182	210	1,470	$60	$615K
T1015	Clinic visit/encounter, all-inclusive	192	350	3,560	$30	$525.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	113	280	600	$90	$299K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	77	90	730	$60	$275.7K
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…	118	2,770	210	$60	$254.5K
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…	431	2,480	350	$80	$246K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	108	380	160	$100	$226.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	90	120	1,100	$30	$170.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	57	390	100	$100	$148.3K
87081	The lab analyst cultures a patient specimen on a test medium designed to grow only a specific pathogenic organism.	85	90	720	$40	$110.7K

Showing 1–10 of 52

Related Providers

Other providers that share a Tax Identification Number (TIN) with St. James Health And Wellness Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Bonno	SC	Advanced Heart Failure and Transplant Cardiology Physician	$112.9K	$0

Nearby Providers

Other providers in the same ZIP code as St. James Health And Wellness Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Georgetown Memorial Hospital	SC	General Acute Care Hospital	$0	$27.6M
Georgetown County Board Of Disabilities And Special Needs	SC	Developmentally Disabled Services Day Training Agency	$0	$13.8M
Es Pediatric Partners LLC	SC	Pediatrics Physician	$0	$13.2M
Georgetown County School District	SC	Local Education Agency (LEA)	$0	$5.3M
Active Sc Two, Inc.	SC	Adult Day Care Clinic/Center	$0	$2.1M
Bay Microsurgical Unit	SC	Ambulatory Surgical Clinic/Center	$1.8M	$113.9K
South Strand Oral & Maxillofacial Surgery	SC	Oral and Maxillofacial Surgery (Dentist)	$0	$1.6M
County Of Georgetown	SC	Ambulance	$450.4K	$1.1M
Catherine Doegg	SC	Ophthalmology Physician	$1.4M	$0
Richard Dechamplain	SC	Ophthalmology Physician	$498.3K	$0

St. James Health And Wellness Inc. — Billing Profile & Reimbursement Data

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St. James Health And Wellness 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