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.

State Of South Carolina (NPI 1659457778)

Field	Value
Entity Type	Organization
Organization	State Of South Carolina
Address	1931 Industrial Park Road
City	Conway
State	SC
ZIP	29526
Taxonomy	Public Health or Welfare Agency
NPI Enumerated	October 31, 2006

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	10,710	$70	$739.2K
H1001	Prenatal care, at-risk enhanced service; antepartum management	2,540	$170	$439.9K
T1001	Nursing assessment / evaluation	2,000	$170	$342K
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…	4,590	$50	$211.3K
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,…	6,580	$30	$177.6K
99204	The provider sees a new 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 provider…	1,330	$110	$142.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,980	$50	$92.9K
99501	A home health provider, such as a registered nurse, visits a patient and her newborn at home to review plans of care and provide additional resources to the patient.	950	$90	$84.2K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	11,080	$10	$66.5K
J1050	Injection, medroxyprogesterone acetate, 1 mg	4,620	$10	$64.7K

Showing 1–10 of 31

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

State Of South Carolina — 6 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H1001	Prenatal care, at-risk enhanced service; antepartum management	5	10	2,070	$170	$401.4K
T1001	Nursing assessment / evaluation	5	10	1,250	$170	$319.9K
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…	387	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…	135	2,480	350	$80	$246K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	112	120	1,100	$30	$170.4K
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,…	27	610	190	$50	$98.4K
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.	167	650	140	$30	$98.1K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	26	380	660	$30	$90K
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…	227	520	70	$70	$67.1K
99204	The provider sees a new 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 provider…	40	490	90	$100	$63.6K

Showing 1–10 of 31

Related Providers

Other providers that share a Tax Identification Number (TIN) with State Of South Carolina, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of South Carolina	SC	Public Health or Welfare Agency	$0	$10.4M
State Of South Carolina	SC	Clinical Medical Laboratory	$0	$9.1M
State Of South Carolina	SC	Public Health or Welfare Agency	$0	$2.9M
State Of South Carolina	SC	Public Health or Welfare Agency	$0	$1.8M
State Of South Carolina	SC	Public Health or Welfare Agency	$0	$1.6M

Nearby Providers

Other providers in the same ZIP code as State Of South Carolina, ranked by combined Medicare and Medicaid revenue.

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
Conway Hospital, Inc.	SC	General Acute Care Hospital	$0	$20.2M
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
Conway Hospital Emergency Professional Services	SC	Emergency Medicine Physician	$0	$6.1M
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

State Of South Carolina — Billing Profile & Reimbursement Data

Sign up for State Of South Carolina — Billing Profile & Reimbursement Data policy alerts

State Of South Carolina — Billing Profile & Reimbursement Data

Sign up for State Of South Carolina — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References