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.

Pelham Medical Center (NPI 1982800397)

Field	Value
Entity Type	Organization
Organization	Pelham Medical Center
Address	250 Westmoreland Rd
City	Greer
State	SC
ZIP	29651
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 22, 2007

Payer Source	Total Paid
Medicaid	$13.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

156 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	20,510	$110	$2.2M
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.	30,970	$60	$1.8M
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	5,270	$320	$1.7M
J7030	Infusion, normal saline solution , 1000 cc	9,700	$170	$1.6M
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	16,060	$50	$867.2K
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…	6,200	$140	$855.6K
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.	3,420	$160	$553.2K
J7120	Ringers lactate infusion, up to 1000 cc	2,320	$210	$478.3K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	4,760	$80	$400.2K
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.	2,110	$130	$274.7K

Showing 1–10 of 156

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

Pelham Medical Center — 0 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

156 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	13	20	350	$1,170	$776.4K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	36	210	1,470	$60	$615K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	260	350	2,590	$70	$550.2K
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.	37	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.	68	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.	68	200	1,680	$50	$443.2K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	40	60	170	$430	$434.9K
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.	57	140	2,520	$90	$415.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	95	290	2,600	$60	$414.4K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	25	110	1,880	$100	$414K

Showing 1–10 of 156

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pelham Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spartanburg Medical Center	SC	General Acute Care Hospital	$0	$187.7M
Spartanburg Medical Center	SC	Emergency Medicine Physician	$0	$17.2M
Spartanburg Medical Center	SC	Family Medicine Physician	$0	$17M
Cherokee Medical Center	SC	General Acute Care Hospital	$0	$15.4M
Spartanburg Medical Center	SC	Maternal & Fetal Medicine Physician	$0	$11.5M
Union Medical Center	SC	General Acute Care Hospital	$0	$10.7M
Spartanburg Medical Center	SC	Community Based Hospice Care Agency	$0	$8.9M
Spartanburg Medical Center	SC	Urgent Care Clinic/Center	$0	$6.3M
Spartanburg Medical Center	SC	Pediatrics Physician	$0	$4.8M
Spartanburg Medical Center	SC	Urgent Care Clinic/Center	$0	$4.2M

Nearby Providers

Other providers in the same ZIP code as Pelham Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aeroflow Inc	SC	Durable Medical Equipment & Medical Supplies	$0	$11.5M
Stay At Home Of The Upstate Inc	SC	In Home Supportive Care Agency	$0	$6.3M
Active Sc Two, Inc.	SC	Adult Day Care Clinic/Center	$0	$2.5M
Medasic	SC	Addiction (Substance Use Disorder) Counselor	$0	$1.9M
Anthony Mathis	SC	Foot & Ankle Surgery Podiatrist	$202.2K	$0
Jonathan Bulzan	SC	Diagnostic Radiology Physician	$153.7K	$0
John Walton	SC	Urology Physician	$127.2K	$0
Emily Hartsuiker	SC	Physical Therapist	$43.3K	$0

Pelham Medical Center — 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

Nearby Providers

Frequently Asked Questions

References