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.

Optimum Healthcare (NPI 1497075121)

Field	Value
Entity Type	Organization
Organization	Optimum Healthcare
Address	622a Old Easley Hwy
City	Greenville
State	SC
ZIP	29611
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	June 4, 2010

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	21,880	$70	$1.6M
T1002	Rn services, up to 15 minutes	1,160	$350	$402.6K
S5130	Homemaker service, nos; per 15 minutes	2,490	$20	$57.2K
T1003	Lpn/lvn services, up to 15 minutes	270	$170	$46.4K

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

Optimum Healthcare — 0 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	62	100	33,410	$70	$4.6M
S5130	Homemaker service, nos; per 15 minutes	65	80	27,870	$20	$816K
T1002	Rn services, up to 15 minutes	80	100	5,080	$60	$611.2K
T1003	Lpn/lvn services, up to 15 minutes	28	40	1,440	$110	$417K

Nearby Providers

Other providers in the same ZIP code as Optimum Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$10.7M
Twin Med, LLC	SC	Durable Medical Equipment & Medical Supplies	$0	$5.9M
Acsr, Inc.	SC	Adult Day Care Clinic/Center	$0	$4.8M
Kool Smiles, PC	SC	General Practice Dentistry	$0	$4.3M
Allegiant Pediatrics LLC	SC	Pediatric Physical Therapist	$0	$4.1M
Family Dental Center, LLC	SC	General Practice Dentistry	$0	$2.7M
Prisma Health-upstate	SC	Rural Health Clinic/Center	$0	$1.8M
Lee Carson	SC	Dermatology Physician	$439.8K	$910
Bradley Williams	SC	Nurse Practitioner	$213.2K	$0
Melissa Danner	SC	Nurse Practitioner	$181.2K	$0

Optimum Healthcare — Billing Profile & Reimbursement Data

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Optimum Healthcare — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References