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.

Genesis Health Care, Inc (NPI 1558831198)

Field	Value
Entity Type	Organization
Organization	Genesis Health Care, Inc
Address	124 Medical Park Dr
City	Walterboro
State	SC
ZIP	29488
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 27, 2018

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.

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	3,340	$200	$654.8K
T1015	Clinic visit/encounter, all-inclusive	3,110	$210	$652.3K
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…	1,100	$190	$213.4K
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…	920	$190	$177.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	770	$200	$150.2K
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…	420	$200	$85.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	400	$200	$79.8K
99203	The provider sees a new 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 provider…	110	$200	$22.8K
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,…	60	$190	$10.3K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	40	$210	$7.7K

Showing 1–10 of 36

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

Genesis Health Care, Inc — 0 of 18 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

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	196	350	3,560	$30	$525.5K
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…	123	280	600	$90	$299K
0241U	N/A	46	50	1,840	$90	$291.4K
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…	477	2,770	210	$60	$254.5K
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…	1,185	2,480	350	$80	$246K
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…	120	380	160	$100	$226.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	120	390	100	$100	$148.3K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	150	170	500	$50	$128.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	120	340	110	$110	$107.9K
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,…	410	610	190	$50	$98.4K

Showing 1–10 of 36

Related Providers

Other providers that share a Tax Identification Number (TIN) with Genesis Health Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Genesis Healthcare, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$3.3M
Genesis Healthcare, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$2M
Genesis Healthcare, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$1.9M
Alexander Cohen	SC	Family Medicine Physician	$128.6K	$22.3K
Timothy Myers	MN	Diagnostic Radiology Physician	$113.6K	$27.6K
Priscilla Welch	SC	Family Medicine Physician	$100.1K	$5.9K
Michael Barrett	SC	Family Medicine Physician	$64.8K	$0
Brian Heaster	SC	Family Medicine Physician	$56.1K	$0
Isabel Mendoza	SC	Family Medicine Physician	$39.6K	$3.3K

Nearby Providers

Other providers in the same ZIP code as Genesis Health Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Colleton County Board Of Disabilities And Special Needs	SC	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$16.7M
Walterboro Community Hospital, Inc.	SC	General Acute Care Hospital	$0	$11.8M
Walterboro Family Practice Associates, P.A.	SC	Family Medicine Physician	$0	$7M
Colleton County School District	SC	Speech-Language Pathologist	$0	$3.1M
Walterboro Adult & Pediatric Medicine, LLC	SC	Rural Health Clinic/Center	$0	$2.2M
County Of Colleton	SC	Ambulance	$518.9K	$1.5M
Beacon Respiratory Services Of Georgia, Inc	SC	Oxygen Equipment & Supplies (DME)	$0	$1.7M
Med-trans Corporation	SC	Air Ambulance	$544K	$0
Vlastimil Smetka	SC	Family Medicine Physician	$457.3K	$0
Jeffrey Kramer	SC	Internal Medicine Physician	$299K	$0

Genesis Health Care, Inc — Billing Profile & Reimbursement Data

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Genesis Health Care, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References