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.

Eau Claire Cooperative Health Center, Inc. (NPI 1346249430)

Key Findings

Field	Value
Entity Type	Organization
Organization	Eau Claire Cooperative Health Center, Inc.
Address	1228 Harden St
City	Columbia
State	SC
ZIP	29204
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 20, 2005

Payer Source	Total Paid
Medicaid	$84.5M
Medicare	$0

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. is effectively a Medicaid-focused Federally Qualified Health Center: no Medicare billing is on file while lifetime Medicaid revenue totals $84.5M, indicating the organization operates primarily within the Medicaid program and should be treated as a single-payer provider for the purposes of Medicare vs. Medicaid analyses. The NPI has been enumerated since 2005-07-20 (~21 years), showing long-tenure operation in the market.

Revenue concentration is high: the top three Medicaid codes by revenue account for 67.8% of the provider’s total Medicaid revenue, indicating that a few ambulatory/preventive visit codes drive most of financial activity and that changes to reimbursement or utilization for those codes would materially impact overall revenue.

The largest single revenue line is T1015 (Clinic visit/encounter, all-inclusive) with $30.1M (35.8% of Medicaid revenue) and 203.1K claims; EAU CLAIRE ranks #7 of 353 providers in-state (98th percentile). This positions the center as a high-volume clinic experience modelually focused on bundled, comprehensive clinic encounters typical of FQHCs, and it is a leading statewide provider for this clinic-encounter payment.

99213 (established office visit) is a second dominant driver at $20.5M (24.4% of Medicaid revenue) across 112.5K claims and ranks #9 of 2766 providers (100th percentile). High volume for 99213 signals that the practice delivers large ambulatory primary care visit volumes consistent with chronic care and routine outpatient management, and its 100th-percentile standing marks it as an extreme statewide outlier in visit volume.

Preventive and well-child services are a distinct service line for the center: 99391, 99392, 99393, and 99394 together represent multi-million dollar lines (for example 99391 at $6.5M, 99392 at $5.4M, 99393 at $4.5M, 99394 at $3.2M) and each ranks at or near the top percentiles in-state (99th–100th percentile for multiple codes). These patterns indicate a strong pediatric and preventive care footprint that aligns with the FQHC mission and with high immunization and well-visit throughput (also supported by 90460 at 61.5K claims).

Several codes show extreme or notable statewide outlier status signaling specialization and scale: 99213 is an "extreme outlier" (100th percentile) and T1015 is "notably above typical" (98th percentile), while pediatric preventive codes such as 99393 and 99394 are also labeled "extreme outlier" in-state. Collectively, these rankings indicate the center is a major regional player for routine primary care and preventive pediatrics within South Carolina.

Service breadth includes behavioral health and ancillary services but at much smaller shares of revenue: psychotherapy codes 90832 and 90837 and psychiatric evaluation codes (90791) appear with modest revenue shares (each under 1% of Medicaid revenue) and typical percentile rankings, suggesting these services exist but are not primary revenue drivers. Additional ancillary activity is visible in lab testing (87428), vaccination administration (90460), and family planning injections (J1050), each ranked notably high in-state, reinforcing a multi-service community health center model.

Given the long NPI tenure (~21 years) combined with concentrated dependence on a few high-volume outpatient visit codes, the provider’s financial and operational risk is correlated to outpatient visit demand and Medicaid policy for primary care and FQHC-type clinic encounter payments. Any policy or utilization changes affecting T1015, 99213, or the major preventive visit codes would likely have outsized impact on revenue and operational throughput.

Medicaid: Complete Services Breakdown

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

151 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	203,120	$150	$30.1M
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…	112,500	$180	$20.5M
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…	35,080	$180	$6.5M
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…	28,960	$190	$5.4M
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…	27,940	$180	$5M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	24,550	$190	$4.5M
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,…	20,580	$180	$3.7M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	17,340	$190	$3.2M
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.	61,490	$20	$1.4M
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	15,580	$60	$935K

Showing 1–10 of 151

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

Eau Claire Cooperative Health Center, Inc. — 13 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

151 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	150	210	320	$130	$707.4K
T1015	Clinic visit/encounter, all-inclusive	7	350	3,560	$30	$525.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	187	650	800	$120	$413.8K
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…	12	60	50	$960	$381.4K
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…	4	280	600	$90	$299K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	32	160	270	$70	$268.1K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	94	240	260	$160	$257.9K
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…	9	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	50	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…	39	2,480	350	$80	$246K

Showing 1–10 of 151

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolina Radiology Associates LLC	SC	Diagnostic Radiology Physician	$0	$9.2M
John Razook	SC	Diagnostic Radiology Physician	$710.6K	$0
Syed Akbar	IL	Diagnostic Radiology Physician	$280.8K	$223.7K
Brian Thurber	TN	Diagnostic Radiology Physician	$356K	$0
Gregory Mencken	SC	Diagnostic Radiology Physician	$346.9K	$0
Brian Trotta	NC	Diagnostic Radiology Physician	$305.7K	$400
Russell Derrick	SC	Diagnostic Radiology Physician	$293.1K	$240
Steven Pirttima	SC	Diagnostic Radiology Physician	$277.5K	$470
Christopher Degn	NV	Diagnostic Radiology Physician	$272.2K	$0
Jean-martin Gingras	VA	Diagnostic Radiology Physician	$269.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Mentor, Inc.	SC	Mental Illness Community Based Residential Treatment Facility	$0	$54.8M
County Council For Richland County	SC	Ambulance	$4M	$12.4M
Providence Hospital, LLC	SC	General Acute Care Hospital	$0	$12.7M
Family Preservation Community Services	SC	Community/Behavioral Health Agency	$0	$11.1M
Pediatric Associates, P.A.	SC	Preferred Provider Organization	$0	$7.6M
Two Notch Road Dental Health Center	SC	General Practice Dentistry	$0	$5.7M
She's Counseling Trichology & Consulting LLC	SC	Professional Counselor	$0	$5.4M
Guardian Angel Home Care Services,llc	SC	Home Health Agency	$0	$5.3M
All Medical Inc	SC	Durable Medical Equipment & Medical Supplies	$0	$5M
South Carolina Public Charter School District	SC	Local Education Agency (LEA)	$0	$4.9M

Eau Claire Cooperative Health Center, Inc. — Billing Profile & Reimbursement Data

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Eau Claire Cooperative Health Center, Inc. — 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