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.

Grand Strand Pediatrics & Adolescent Medicine, P.A. (NPI 1588614192)

Key Findings

Field	Value
Entity Type	Organization
Organization	Grand Strand Pediatrics & Adolescent Medicine, P.A.
Address	8120 Rourk St
City	Myrtle Beach
State	SC
ZIP	29572
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$28M
Medicare	$0

This provider is effectively single-payer: there is no Medicare billing on file while reported Medicaid revenue totals $28M, so Medicaid accounts for the entirety of documented lifetime federal-program revenue. The absence of Medicare activity combined with material Medicaid volume indicates operations are focused on publicly insured pediatric populations rather than dual Medicare/Medicaid practice mix.

Revenue is highly concentrated in a few evaluation-and-management and preventive codes: the top 3 Medicaid codes by revenue account for 58.3% of this provider's total Medicaid revenue. Those three codes are 99213 ($7.8M revenue from 109.9K claims), 99214 ($6.2M revenue from 60K claims), and 99392 ($2.2M revenue from 21.1K claims), which together dominate reported Medicaid receipts.

The code mix indicates a high-volume pediatric primary care and preventive practice: large volumes of established office visits (99213, 99214) and well-child/preventive visits (99392, 99393, 99394, 99391) are the primary service lines. Immunization administration (90460 with 59.3K claims, $2M revenue and 90461 with 25.4K claims, $583.2K revenue) and routine screening services (99177 vision screening, 99177 – 7.7K claims) further support a comprehensive outpatient pediatric clinic model.

Competitive standing within South Carolina is dominant for core pediatric visit codes: 99213 ranks #11 of 2766 providers in-state (100th percentile; extreme outlier) and 99214 ranks #13 of 2483 providers in-state (100th percentile; extreme outlier), while 99392 ranks #7 of 377 providers in-state (98th percentile; notably above typical state volume). These rank/percentile placements indicate the practice is a major/high-volume Medicaid pediatric provider in the state for routine and preventive care.

Ancillary diagnostic and infectious-disease testing and vaccination services are also meaningful revenue contributors. High-volume vaccine administration is reflected in 90460 (59.3K claims, $2M revenue; ranks #7 of 652, 99th percentile; extreme outlier) and 90461 (25.4K claims, $583.2K revenue; ranks #4 of 456, 99th percentile; extreme outlier), while respiratory testing codes such as 87426 (12.8K claims, $691K revenue; ranks #7 of 236, 97th percentile; extreme outlier) and 87636 (6.3K claims, $914.8K revenue; ranks #7 of 69, 91th percentile; typical, unremarkable volume) show a substantial testing footprint.

The provider offers a notable non-standard pediatric service line in nutrition therapy: 97802 appears with 37.1K claims and $965.7K revenue and ranks #1 of 129 providers in-state (100th percentile; extreme outlier). This strongly suggests an integrated diet-therapy or nutrition counseling capability that is unusually large compared with in-state peers.

Well-care coverage spans the pediatric age range with multiple preventive visit codes reporting high volume and above-typical state rankings: 99393 (16.8K claims, $1.7M revenue; ranks #6 of 389, 99th percentile; extreme outlier) and 99394 (11.2K claims, $1.3M revenue; ranks #4 of 338, 99th percentile; extreme outlier) demonstrate capacity to deliver preventive visits for both younger children and adolescents. The breadth of these preventive codes, combined with the E/M volume, indicates a full-spectrum outpatient pediatric practice rather than a narrow specialty clinic.

The provider has an established presence with an NPI enumerated on 2006-05-12 (~20 years ago), signaling long tenure in the market. Combined with the concentrated Medicaid revenue and consistently high state rankings across multiple codes, this suggests a sustained, Medicaid-focused pediatric operation with entrenched patient volume over time.

Medicaid: Complete Services Breakdown

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

74 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…	109,900	$70	$7.8M
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…	59,980	$100	$6.2M
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…	21,070	$100	$2.2M
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.	59,300	$30	$2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	16,840	$100	$1.7M
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…	17,460	$100	$1.7M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	11,190	$110	$1.3M
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	37,140	$30	$965.7K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	6,270	$150	$914.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	12,800	$50	$691K

Showing 1–10 of 74

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

Grand Strand Pediatrics & Adolescent Medicine, P.A. — 15 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

74 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	474	650	800	$120	$413.8K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	7	70	600	$130	$307.2K
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…	12	280	600	$90	$299K
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…	37	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…	11	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…	13	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…	7	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…	186	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.	6	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.	4	340	110	$110	$107.9K

Showing 1–10 of 74

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Acs Primary Care Physicians - Southeast PC	SC	Emergency Medicine Physician	$0	$81.7M
Grand Strand Regional Medical Center LLC	SC	General Acute Care Hospital	$0	$27.4M
Carolina Regional Surgery Center. Ltd	SC	Ambulatory Surgical Clinic/Center	$3M	$1.7M
Coastal Carolina Primary Care, LLC	SC	Endocrinology, Diabetes & Metabolism Physician	$0	$4M
Brandon Coakley	SC	MOHS-Micrographic Surgery Physician	$3.5M	$0
Parkway Surgery Center	SC	Ambulatory Surgical Clinic/Center	$3.5M	$0
Jordan Henderson	SC	Hematology & Oncology Physician	$3.1M	$0
Dejuania Brown-rawls	SC	Hematology & Oncology Physician	$2.8M	$0
David Lazar	SC	Rheumatology Physician	$2.7M	$0
Stephen Hammond	SC	Dermatopathology Physician	$2.3M	$0

Grand Strand Pediatrics & Adolescent Medicine, P.A. — Billing Profile & Reimbursement Data

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Grand Strand Pediatrics & Adolescent Medicine, P.A. — 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

Nearby Providers

Frequently Asked Questions

References