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.

Conway Hospital, Inc. (NPI 1558835355)

Conway Hospital, Inc. is a pediatrics physician provider located in Conway, South Carolina. This profile covers 0 Medicare and 37 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Conway Hospital, Inc.
Address	124 Professional Park Drive, Ste A
City	Conway
State	SC
ZIP	29526
Taxonomy	Pediatrics Physician
NPI Enumerated	January 15, 2019

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

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

37 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…	12,400	$70	$843.5K
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…	5,580	$100	$535.4K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	4,080	$90	$359.2K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	3,950	$70	$264.7K
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…	1,950	$100	$197.4K
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…	1,970	$90	$185.1K
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.	4,770	$30	$162.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	900	$100	$91.4K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	2,310	$40	$80.9K
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…	810	$60	$49.1K

Showing 1–10 of 37

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

Conway Hospital, Inc. — 1 of 22 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

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	86	280	600	$90	$299K
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…	202	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…	281	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…	93	380	160	$100	$226.8K
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…	307	410	330	$50	$152.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	110	390	100	$100	$148.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	131	340	110	$110	$107.9K
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.	97	650	140	$30	$98.1K
G9153	Mapcp demonstration - physician incentive pool	66	140	420	$50	$91.9K
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…	46	140	270	$60	$89.1K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Conway Hospital, Inc.	SC	General Acute Care Hospital	$0	$20.2M
Conway Hospital Emergency Professional Services	SC	Emergency Medicine Physician	$0	$6.1M
Conway Hospital Inc	SC	Pediatrics Physician	$0	$4.9M
Conway Hospital, Inc.	SC	Obstetrics & Gynecology Physician	$0	$2.2M
Andrew Gresko	SC	Clinical Cardiac Electrophysiology Physician	$789.5K	$0
Victoriya Strukova	SC	Rheumatology Physician	$624.4K	$0
Kenneth Santiago	SC	Internal Medicine Physician	$467.1K	$0
Pansy Cooper	SC	Family Nurse Practitioner	$447.5K	$710
Michael Rosenblum	SC	Cardiovascular Disease Physician	$429.4K	$0
Michael Zdunich	SC	Medical Physician Assistant	$344.8K	$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	$40.5M
Horry County Disabilities & Special Needs Board	SC	Developmentally Disabled Services Day Training Agency	$0	$25.7M
Health Care Partners Of South Carolina, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$10.7M
Carolina Radiology Associates LLC	SC	Diagnostic Radiology Physician	$0	$9.2M
Horry County Government	SC	Land Ambulance	$4M	$4.4M
Coastal Pediatrics	SC	Primary Care Clinic/Center	$0	$5.1M
Carolina Care Medical Supply LLC	SC	Durable Medical Equipment & Medical Supplies	$0	$4.9M
Nicholas Marchase	SC	Ophthalmology Physician	$4.1M	$306.4K
Horry County Comm On Alcohol & Drug Abuse	SC	Community/Behavioral Health Agency	$0	$4.2M
Palmetto Pediatrics Of Conway	SC	Specialist	$0	$4M

Conway Hospital, 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

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