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.

Coastal Carolina Primary Care, LLC (NPI 1821257676)

Coastal Carolina Primary Care, LLC is a endocrinology, diabetes & metabolism physician provider located in Myrtle Beach, South Carolina. This profile covers 0 Medicare and 45 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	Coastal Carolina Primary Care, LLC
Address	920 Doug White Dr Ste 250
City	Myrtle Beach
State	SC
ZIP	29572
Taxonomy	Endocrinology, Diabetes & Metabolism Physician
NPI Enumerated	June 6, 2008

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

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

45 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…	34,850	$60	$2M
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…	7,190	$70	$481.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	5,020	$80	$391.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	9,840	$40	$344.4K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	6,580	$30	$203.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,730	$50	$171.8K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	2,900	$30	$90K
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.	6,740	$10	$40.4K
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…	250	$100	$25.5K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	180	$130	$23.1K

Showing 1–10 of 45

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

Coastal Carolina Primary Care, LLC — 2 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

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	57	90	260	$430	$688.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	47	60	50	$960	$381.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	5	40	510	$170	$302.7K
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…	60	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	231	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…	213	2,480	350	$80	$246K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	5	100	240	$100	$187.3K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	42	110	70	$150	$157.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	7	70	150	$70	$156.2K
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…	189	410	330	$50	$152.6K

Showing 1–10 of 45

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Mccaffrey	SC	Neurology Physician	$723.1K	$0
Lisa Mount	SC	Internal Medicine Physician	$444K	$0
Thomas Anderson	SC	Neurological Surgery Physician	$387.6K	$0
Barbara Sarb	SC	Pain Medicine (Psychiatry & Neurology) Physician	$381.1K	$0
Catherine Brignoni	CA	Neurology Physician	$328.9K	$0
Gabriel Phillips	SC	Neurological Surgery Physician	$307.4K	$0
James Smith	SC	Neurological Surgery Physician	$304.6K	$0
Joseph Cheatle	NC	Neurological Surgery Physician	$193.1K	$0
Eugene Giddens	SC	Neurological Surgery Physician	$185K	$0
George Sandoz	SC	Neurology Physician	$164.7K	$5.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Acs Primary Care Physicians - Southeast PC	SC	Emergency Medicine Physician	$0	$81.7M
Grand Strand Pediatrics & Adolescent Medicine, P.A.	SC	Pediatric Adolescent Medicine Physician	$0	$28M
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
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

Coastal Carolina Primary Care, LLC — Billing Profile & Reimbursement Data

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Coastal Carolina Primary Care, LLC — 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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