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.

Acs Primary Care Physicians - Southeast PC (NPI 1861430555)

Field	Value
Entity Type	Organization
Organization	Acs Primary Care Physicians - Southeast PC
Address	809 82nd Pkwy
City	Myrtle Beach
State	SC
ZIP	29572
Taxonomy	Emergency Medicine Physician
NPI Enumerated	June 3, 2006

Payer Source	Total Paid
Medicaid	$81.7M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $81.7M in lifetime Medicaid revenue, making its publicly reported activity effectively single-payer (Medicaid) at the dataset level. The absence of Medicare claims should be treated as a material characteristic when assessing payer mix and contracting exposure.

Revenue is extremely concentrated in three emergency department E/M codes: 99284 ($36.7M, 45.0% of Medicaid revenue), 99285 ($28M, 34.3% of Medicaid revenue), and 99283 ($16.6M, 20.3% of Medicaid revenue); together these top three codes account for 99.6% of the provider’s reported Medicaid revenue. That precomputed concentration figure highlights that nearly all billed Medicaid dollars flow from a narrow set of ED evaluation-and-management services.

The code mix and the provider’s taxonomy (Emergency Medicine Physician) align: 99284 is described as a moderate-complexity ED evaluation, 99285 as high-complexity ED evaluation, and 99283 as a low-complexity ED evaluation. High claim volumes reported for these codes (453.4K claims for 99284, 277.7K for 99285, and 360.6K for 99283) are consistent with a high-throughput emergency-department operation rather than an ambulatory primary-care or specialty clinic.

State-level competitive standing on these primary revenue codes is dominant: the provider ranks #1 in-state for 99284 (of 353 providers), 99285 (of 199 providers), and 99283 (of 341 providers), each listed at the 100th percentile and characterized as an extreme outlier far above typical state volume. Those rank and percentile indicators signal this entity is a major statewide player for Medicaid ED E/M services and is far above typical provider volumes for the same codes.

Ancillary and non-ED services contribute negligible Medicaid revenue relative to the ED codes; for example, 93010 (ECG interpretation) produced $179.7K (0.2% of Medicaid revenue) and 99053 (overnight facility services) produced $27.8K (0.0% of Medicaid revenue). Even where some ancillary codes are high-percentile outliers by rank (93010 ranks #5 of 155 at the 97th percentile), their dollar contribution is tiny compared with the ED E/M revenue, indicating limited diversification of billed services.

High-acuity services such as critical care billed under 99291 are present but minimal in revenue and volume (181 claims, $20.8K revenue, listed as 0.0% of Medicaid revenue and a typical volume by percentile). Routine office/outpatient E/M codes (for example 99203, 99213, 99214) also show only modest claim counts and small revenue shares, reinforcing that this practice’s operational focus is emergency-department evaluations rather than office-based longitudinal care.

The provider’s NPI was enumerated on 2006-06-03 (~20 years ago), indicating an established presence in the market; the longevity combined with the very large Medicaid ED volumes suggests sustained specialization in emergency-department services rather than a recent shift in business model. Analysts should consider tenure when evaluating historical utilization patterns and competitive position.

From a payer/contracting perspective, the combination of single-payer Medicaid scale and extreme revenue concentration in ED E/M codes means this entity is a critical source of Medicaid emergency services in-state. Payers evaluating network adequacy, utilization management, or rate negotiations should focus on ED visit utilization patterns and the three dominant codes (99284, 99285, 99283) because changes in payment or access for those codes would materially affect total Medicaid spend with this provider.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	453,400	$80	$36.7M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	277,660	$100	$28M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	360,560	$50	$16.6M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	44,930	$1	$179.7K
99053	The provider renders overnight services at a 24 hour facility.	27,800	$1	$27.8K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	830	$30	$25.9K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	180	$120	$20.8K
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…	220	$80	$17.5K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	240	$50	$12.5K
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…	340	$40	$12.2K

Showing 1–10 of 22

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

Acs Primary Care Physicians - Southeast PC — 5 of 19 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	1	340	110	$40	$450.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	1	350	100	$50	$446.9K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	1	200	1,680	$50	$443.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	86	140	2,520	$90	$415.3K
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…	1,224	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…	1,613	2,480	350	$80	$246K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	30	50	340	$80	$129.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	172	170	500	$50	$128.5K
S9083	Global fee urgent care centers	4	10	460	$130	$110.4K
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,…	124	240	280	$50	$78.4K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Acs Primary Care Physicians - Southeast PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ajay Kumar	GA	Internal Medicine Physician	$135.3K	$0
Susan Hackman-quinty	SC	Family Medicine Physician	$127.8K	$0
Marshall Wise	SC	Emergency Medicine Physician	$125.7K	$0
Hicham Churbaji	MI	Internal Medicine Physician	$117.1K	$0
Michael Boone	CA	Emergency Medicine Physician	$114.8K	$1.2K
Radley Short	PA	Emergency Medicine Physician	$95.6K	$590
Mary Crowder	TN	Physician Assistant	$93.9K	$0
Louis Argentine	SC	Emergency Medicine Physician	$92.2K	$0
Mark Hanna	NC	Emergency Medicine Physician	$91.3K	$560
Andrew Krieger	NC	Emergency Medicine Physician	$91.8K	$0

Nearby Providers

Other providers in the same ZIP code as Acs Primary Care Physicians - Southeast PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
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

Acs Primary Care Physicians - Southeast PC — Billing Profile & Reimbursement Data

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Acs Primary Care Physicians - Southeast PC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References