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.

Health Promotion Specialists (NPI 1336105527)

Field	Value
Entity Type	Organization
Organization	Health Promotion Specialists
Address	100 Old Cherokee Rd
City	Lexington
State	SC
ZIP	29072
Taxonomy	Dental Hygienist
NPI Enumerated	April 25, 2006

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1351	Sealant - per tooth	74,800	$30	$2.2M
D1120	Prophylaxis–child	37,060	$40	$1.3M
D2940	N/A	17,010	$50	$816.2K
D0150	Comprehensive oral evaluation – new or established patient	19,330	$40	$811.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	8,500	$50	$425.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	24,360	$20	$414.2K
D1208	Topical application of fluoride - excluding varnish	21,370	$20	$342K
D0120	Periodic oral evaluation - established patient	3,430	$30	$85.6K
D1354	N/A	4,190	$10	$58.6K
D0140	Limited oral evaluation – problem focused	120	$40	$4.5K

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

Health Promotion Specialists — 6 of 10 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2940	N/A	2	10	100	$50	$339.8K
D1120	Prophylaxis–child	8	470	600	$30	$156.7K
D1351	Sealant - per tooth	1	200	840	$30	$108.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	19	590	850	$50	$104.9K
D0120	Periodic oral evaluation - established patient	143	610	1,060	$20	$100K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	21	410	670	$20	$95.1K
D0150	Comprehensive oral evaluation – new or established patient	6	510	290	$40	$51.6K
D1208	Topical application of fluoride - excluding varnish	8	300	750	$20	$43.3K
D0140	Limited oral evaluation – problem focused	299	440	360	$40	$35.2K
D1354	N/A	2	20	310	$10	$8.9K

Nearby Providers

Other providers in the same ZIP code as Health Promotion Specialists, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Medical Management, LLC	SC	Pediatrics Physician	$0	$43.9M
Allcaregivers, Inc.	SC	Nursing Care Agency	$0	$33.3M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$32M
Lexington County Ems	SC	Ambulance	$2.9M	$6.9M
Lexington Health Inc	SC	Urgent Care Clinic/Center	$0	$8.7M
Key Care Health Services, LLC	SC	Home Health Agency	$0	$8.5M
Capital City Therapy Group, LLC	SC	Specialist	$0	$7.3M
Lexington School District One	SC	Local Education Agency (LEA)	$0	$5.7M
Lexington Health Inc	SC	Pediatric Adolescent Medicine Physician	$0	$5.7M
Amedisys Sc, LLC	SC	Home Health Agency	$0	$4.5M

Health Promotion Specialists — Billing Profile & Reimbursement Data

Sign up for Health Promotion Specialists — Billing Profile & Reimbursement Data policy alerts

Health Promotion Specialists — Billing Profile & Reimbursement Data

Sign up for Health Promotion Specialists — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References