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.

Self Regional Healthcare (NPI 1407887003)

Key Findings

Field	Value
Entity Type	Organization
Organization	Self Regional Healthcare
Address	1325 Spring St
City	Greenwood
State	SC
ZIP	29646
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicaid	$58.8M
Medicare	$0

SELF REGIONAL HEALTHCARE has no Medicare billing on file and is effectively a single‑payer Medicaid provider, with Total Medicaid revenue of $58.8M reported. This concentration means that Medicaid reimbursement patterns will largely determine the facility’s revenue risk and contracting leverage in its market rather than Medicare dynamics.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 39.9% of the provider’s Medicaid revenue. Those top drivers are 96361 ($7.4M, 17.3%), 36415 ($5.7M, 13.3%), and 80053 ($4M, 9.3%), indicating a small group of services disproportionately shapes margins and cash flow.

The code mix points to a service line built around high-throughput infusion and ED/outpatient diagnostic work: 96361, 96365, 96372 and 96360 together signal substantial IV/infusion activity; 36415 and the lab panels (80053, 80048) indicate very large phlebotomy and lab volumes; and ED E/M codes (99283, 99282) plus high-volume imaging support an acute-care hospital operating a busy outpatient and emergency front end. This pattern is consistent with a general acute care hospital that also functions as a regional hub for infusions, labs, and imaging.

Several individual codes show a dominant competitive position in-state. 36415 is an extreme outlier, far above typical state volume for this code (60.3K claims; ranks #9 of 713 providers in-state, 99th percentile), while 96361 ranks #5 of 103 providers in-state (96th percentile; notably above typical state volume for this code). Advanced imaging/processing services such as 76376 rank #1 of 16 providers in-state (100th percentile; extreme outlier), and 72148 also ranks #1 of 61 providers in-state (100th percentile; extreme outlier), signaling local leadership in certain imaging capabilities.

Operational throughput is striking: multiple codes have very large claim counts that support the revenue totals rather than relying on high unit prices alone — examples include 80053 at 66.1K claims, 36415 at 60.3K claims, and 97110 at 47.2K claims. These volumes imply well‑developed ambulatory lab, therapy, and specimen‑collection workflows that drive recurring Medicaid revenue.

The provider also bills several high‑average‑paid services, indicating access to higher‑cost diagnostic capacity. Notable examples include 73721 at $753 avg paid/claim ($1.1M revenue), 72148 (rank #1 in-state) and PET agent A9552 at $1467 avg paid/claim ($544.3K revenue), which together suggest on‑site advanced imaging and specialty diagnostic capability in addition to high-volume routine testing.

Rehabilitation and ambulatory therapy are material service lines: 97110 (47.2K claims, $2.4M revenue, 5.5% of Medicaid revenue) and 97530 (15.7K claims, $438.8K revenue) together represent a sustained outpatient therapy throughput that supplements acute care services. The combination of therapy, ED, infusion, and lab codes points to an integrated inpatient/outpatient platform with multiple revenue levers within Medicaid.

SELF REGIONAL HEALTHCARE’s NPI was enumerated on 2006-07-05 (~20 years ago), indicating long tenure in the market. Combined with the facility’s high percentile rankings on key codes and dominant Medicaid revenue footprint, the data describe a well‑established regional acute care provider whose competitive strength lies in high-volume lab, infusion, imaging, and therapy services billed to Medicaid.

Medicaid: Complete Services Breakdown

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

441 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	19,050	$390	$7.4M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	60,310	$90	$5.7M
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.	66,140	$60	$4M
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…	28,090	$120	$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…	47,230	$50	$2.4M
76376	In this procedure, the provider performs 3D rendering for computed tomography magnetic resonance imaging, ultrasound, or another tomographic modality, typically for diagnostic purposes, with…	20,960	$100	$2M
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	32,160	$60	$2M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	8,160	$240	$1.9M
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	13,480	$140	$1.8M
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.	31,780	$40	$1.4M

Showing 1–10 of 441

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

Self Regional Healthcare — 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

441 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	8	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…	48	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.	5	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.	53	350	2,590	$70	$550.2K
T1015	Clinic visit/encounter, all-inclusive	232	350	3,560	$30	$525.5K
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.	36	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.	37	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.	11	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…	14	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.	23	140	2,520	$90	$415.3K

Showing 1–10 of 441

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greenwood Genetic Center Lab	SC	Clinical Medical Laboratory	$0	$31.2M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$29.1M
Carolina Health Centers, Inc.	SC	Pediatrics Physician	$0	$20.2M
Carolina Health Centers, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$3.3M
Greenwood Treatment Specialists	SC	Methadone Clinic	$75.9K	$3.2M
Greenwood County Ems	SC	Ambulance	$905.9K	$2.2M
Taylor Mader	SC	Rheumatology Physician	$3.1M	$0
Greenwood Obstetrics & Gynecology PA	SC	Obstetrics & Gynecology Physician	$0	$2.7M
Health Related Personnel Services, Inc.	SC	Physical Disabilities Residential Treatment Facility	$0	$2.6M
Greenwood School District 50	SC	Local Education Agency (LEA)	$0	$2.3M

Self Regional Healthcare — Billing Profile & Reimbursement Data

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Self Regional Healthcare — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Self Medical Group	SC	Emergency Medicine Physician	$0	$6M
Steven Madden	SC	Hematology & Oncology Physician	$4M	$0
St Francis Physician Services Inc	SC	Family Medicine Physician	$0	$3.3M
Self Medical Group	SC	Pediatrics Physician	$0	$3.3M
Self Medical Group	SC	Urgent Care Clinic/Center	$0	$2.6M
Self Regional Healthcare	SC	Family Medicine Physician	$0	$2.3M
Self Medical Group	SC	Urgent Care Clinic/Center	$0	$2.2M
Kalpesh Purohit	SC	Family Medicine Physician	$2.1M	$0
Kenneth Spearman	CA	Vascular & Interventional Radiology Physician	$1.9M	$0
Self Regional Healthcare	SC	Home Health Agency	$0	$1.7M