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.

Beaufort County Memorial Hospital (NPI 1366436073)

Key Findings

Field	Value
Entity Type	Organization
Organization	Beaufort County Memorial Hospital
Address	955 Ribaut Road
City	Beaufort
State	SC
ZIP	29902
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 8, 2005

Payer Source	Total Paid
Medicaid	$35.9M
Medicare	$0

This provider has no Medicare billing on file and reports $35.9M in total Medicaid revenue, making the observed payer mix effectively single‑payer (Medicaid) in this dataset. The absence of Medicare claims suggests analyses of Medicare market share or fee schedule exposure are not applicable for this entity based on the available data.

Revenue concentration is high among a small number of Medicaid codes: the top three Medicaid codes (36415, 80053, 97110) together account for 36.9% of the provider's total Medicaid revenue. Individually, 36415 accounts for $4.6M (15.5%), 80053 for $4.3M (14.4%), and 97110 for $2.1M (7.0%), indicating a reliance on high-volume lab draws, comprehensive metabolic panels, and therapeutic exercise services for a large share of Medicaid dollars.

The code mix points to a strong outpatient diagnostic and laboratory throughput: 36415 shows 28K claims and 80053 shows 46.2K claims, and 81025 also reports 12.8K claims. The provider’s position as rank #26 of 713 for 36415 (96th percentile) and rank #11 of 212 for 80053 (95th percentile) supports the interpretation that phlebotomy and routine chemistry panels are primary operational drivers.

There is a sizeable rehabilitation and therapy footprint: 97110 (27.7K claims, $2.1M, 7.0%) and 97530 (31K claims, $2M, 6.5%) together generate material Medicaid revenue and high claim volumes. Both codes rank in the upper state percentiles (97110 at 94th among 285 providers and 97530 at 93th among 345 providers) but are described as typical/unremarkable volumes for those specific CPTs, suggesting this is a standard service line rather than a niche specialty.

Infusion and oncology-related services appear as a distinct service line: chemotherapy administration 96413 generates $1.8M (6.0%), and multiple IV administration codes (96372, 96367, 96361, 96365) each contribute multi‑hundred‑thousand to multi‑million dollar amounts. Several of those infusion/administration codes rank highly statewide (for example, 96372 ranks #27 of 409 at the 94th percentile and 96365 ranks #7 of 101 at the 94th percentile), indicating notable in-state capacity for infusion care and oncologic drug administration.

The provider shows concentrated strength in specific diagnostic tests and point‑of‑care respiratory testing: proprietary PLA code 0202U reports 7.8K claims, $710.2K revenue and ranks #1 of 20 providers in-state (100th percentile), signaling a leading role in BioFire RP2.1 respiratory panel testing in South Carolina. Other lab codes flagged as notably above typical state volume include 36415, 80053, 96372, 96365 and 81025, which collectively mark the hospital as a regional hub for high-volume lab and some procedural services.

Emergency department activity contributes to Medicaid revenue but at more moderate per‑claim payments: 99282 ($687.8K, 12.3K claims) and 99283 ($505.2K, 25.3K claims) are present in the top code list and rank in upper state percentiles for ED E/M visits, suggesting steady ED throughput that supports overall facility volumes rather than dominating revenue.

The provider has an established operational history, with NPI enumeration dated 2005-09-08 (~21 years ago), consistent with the facility’s developed clinical lines (lab, therapy, infusion, ED) and its demonstrated high standing on multiple Medicaid codes statewide. This tenure likely underpins the sustained Medicaid volumes and its ability to maintain specialized testing like 0202U at the leading in-state position.

Medicaid: Complete Services Breakdown

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

305 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.	28,050	$170	$4.6M
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.	46,220	$90	$4.3M
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…	27,730	$80	$2.1M
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.	30,960	$60	$2M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	2,660	$670	$1.8M
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…	13,270	$130	$1.7M
96367	The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose…	3,100	$550	$1.7M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	13,710	$120	$1.6M
J7050	Infusion, normal saline solution, 250 cc	5,720	$250	$1.4M
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…	34,730	$40	$1.4M

Showing 1–10 of 305

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

Beaufort County Memorial Hospital — 5 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

305 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	16	20	350	$1,170	$776.4K
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…	21	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.	11	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.	24	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.	46	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.	45	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.	41	200	1,680	$50	$443.2K
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.	11	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…	18	290	2,600	$60	$414.4K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	57	110	1,880	$100	$414K

Showing 1–10 of 305

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lindsay Gamble	SC	Family Nurse Practitioner	$3.7M	$0
John Sylvester	FL	Radiation Oncology Physician	$2.5M	$0
Paul Slota	SC	Cardiovascular Disease Physician	$516.2K	$0
Stuart Smalheiser	SC	Cardiovascular Disease Physician	$382.2K	$110
Louis Plzak	SC	Urology Physician	$365.9K	$0
Vandit Sardana	SC	Adult Reconstructive Orthopaedic Surgery Physician	$332.2K	$0
Stephen Fedec	FL	Cardiovascular Disease Physician	$266.2K	$0
Nicholas Dardes	SC	Internal Medicine Physician	$238.1K	$0
Jonathan Briggs	NJ	Radiation Oncology Physician	$233.6K	$0
Andrea Hucks	SC	Internal Medicine Physician	$226.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23.3M
Beaufort Pediatrics, P.A.	SC	Rural Health Clinic/Center	$0	$5.3M
Acs Emergency Physicians Of Sc PC	SC	Emergency Medicine Physician	$0	$4.5M
Beaufort County School District	SC	Local Education Agency (LEA)	$0	$4.5M
County Council Of Beaufort County	SC	Land Ambulance	$1.9M	$1.8M
Sea Island Pediatrics	SC	Pediatrics Physician	$0	$3.2M
Beaufort Family Dentistry Vsm LLC	SC	General Practice Dentistry	$0	$1.7M
Mark Dean	SC	Sports Medicine (Orthopaedic Surgery) Physician	$883K	$0
Douglas Scott	SC	Orthopaedic Surgery Physician	$616.2K	$0
Walter Schuyler	SC	Pain Medicine Physician	$545.6K	$6K

Beaufort County Memorial 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