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.

Caresouth Carolina, Inc. (NPI 1811930076)

Field	Value
Entity Type	Organization
Organization	Caresouth Carolina, Inc.
Address	3080 Highway 15-401 E
City	Mc Coll
State	SC
ZIP	29570
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 14, 2006

Payer Source	Total Paid
Medicaid	$1.7M
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
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…	3,890	$240	$940.4K
T1015	Clinic visit/encounter, all-inclusive	3,440	$140	$484.8K
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…	890	$200	$176.4K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	850	$30	$28.1K
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…	50	$350	$18K
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,…	150	$50	$7.1K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	130	$30	$3.2K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	2,910	$1	$2.9K
0012A	N/A	50	$40	$2K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	330	$1	$660

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

Caresouth Carolina, Inc. — 0 of 20 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
T1015	Clinic visit/encounter, all-inclusive	185	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…	135	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…	433	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	403	710	350	$60	$247.2K
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…	930	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…	274	410	330	$50	$152.6K
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,…	143	240	280	$50	$78.4K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	56	70	370	$30	$52.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	420	540	350	$20	$52K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	197	500	180	$20	$33K

Showing 1–10 of 31

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caresouth Carolina, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$12.4M
Caresouth Carolina Inc	SC	Federally Qualified Health Center (FQHC)	$0	$7.3M
Caresouth Carolina, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$4.4M
Caresouth Carolina, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$3.2M
Caresouth Carolina, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$2.3M
Caresouth Carolina, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$2.3M
Caresouth Carolina Inc	SC	Federally Qualified Health Center (FQHC)	$0	$2.2M
Caresouth Carolina, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$1.8M
Caresouth Carolina, Inc	SC	Federally Qualified Health Center (FQHC)	$0	$1.7M
Caresouth Carolina Inc	SC	Federally Qualified Health Center (FQHC)	$0	$1.7M

Caresouth Carolina, Inc. — Billing Profile & Reimbursement Data

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Caresouth Carolina, 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

Frequently Asked Questions

References