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.

Hopehealth, Inc (NPI 1568704583)

Field	Value
Entity Type	Organization
Organization	Hopehealth, Inc
Address	520 Thurgood Marshall Hwy
City	Kingstree
State	SC
ZIP	29556
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	March 18, 2013

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

29 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…	7,080	$140	$998K
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…	5,460	$140	$785.7K
T1015	Clinic visit/encounter, all-inclusive	7,770	$60	$481.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	340	$140	$48.6K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	210	$130	$27K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	220	$110	$24.3K
99442	N/A	630	$30	$18.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	70	$150	$11.1K
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.	590	$20	$10K
J1050	Injection, medroxyprogesterone acetate, 1 mg	90	$80	$7.2K

Showing 1–10 of 29

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

Hopehealth, Inc — 0 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	116	210	320	$130	$707.4K
T1015	Clinic visit/encounter, all-inclusive	120	350	3,560	$30	$525.5K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	92	160	270	$70	$268.1K
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…	290	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…	287	2,480	350	$80	$246K
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…	205	410	330	$50	$152.6K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	177	180	1,360	$20	$152.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	211	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.	124	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.	209	650	140	$30	$98.1K

Showing 1–10 of 29

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hopehealth, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$11.3M
Hopehealth, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$11.1M
Hopehealth Hospice & Palliative Care	MA	Community Based Hospice Care Agency	$0	$8.6M
Hopehealth, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$4.6M
Hopehealth Inc	SC	Federally Qualified Health Center (FQHC)	$0	$3.3M
Hopehealth Inc	SC	Federally Qualified Health Center (FQHC)	$0	$2.7M
Wilhelmenia Patterson	SC	Physician Assistant	$159K	$0
Mary Nutter	SC	Family Medicine Physician	$2.2K	$8.2K
Carol Ann Berry	SC	Family Nurse Practitioner	$4.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Williamsburg County Disabilities And Special Needs Board	SC	Developmental Disabilities Clinic/Center	$0	$8.3M
Williamsburg Regional Hospital	SC	Critical Access Hospital	$0	$3.3M
Drucker Drugs And Medical Equipment LLC	SC	Durable Medical Equipment & Medical Supplies	$0	$2M
Adams Life Link Ambulance, LLC	SC	Ambulance	$782.4K	$631K
Michelle Butterworth	SC	Foot & Ankle Surgery Podiatrist	$146.4K	$950
Hopehealth Inc	SC	Community/Retail Pharmacy	$29.7K	$0

Hopehealth, Inc — Billing Profile & Reimbursement Data

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Hopehealth, 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