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 North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North 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. North 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.

Carolinas Medical Center (NPI 1053358945)

Field	Value
Entity Type	Organization
Organization	Carolinas Medical Center
Address	501 Billingsley Rd
City	Charlotte
State	NC
ZIP	28211
Taxonomy	Psychiatric Hospital Unit
NPI Enumerated	June 1, 2006

Payer Source	Total Paid
Medicaid	$20.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

57 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2426	Injection, paliperidone palmitate extended release (invega sustenna), 1 mg	13,100	$790	$10.4M
J0401	Injection, aripiprazole (abilify maintena), 1 mg	2,000	$880	$1.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	79,550	$20	$1.7M
G0378	Hospital observation service, per hour	6,380	$240	$1.5M
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.	3,110	$360	$1.1M
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.	2,820	$360	$1M
Q3014	Telehealth originating site facility fee	26,140	$20	$601.2K
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.	1,380	$370	$503.3K
J2794	Injection, risperidone (risperdal consta), 0.5 mg	1,400	$320	$439.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	13,790	$20	$289.5K

Showing 1–10 of 57

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. North Carolina Distribution

Carolinas Medical Center — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

57 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	100	120	15,180	$230	$5M
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.	205	330	6,130	$130	$2.7M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	132	160	840	$70	$2.3M
J2426	Injection, paliperidone palmitate extended release (invega sustenna), 1 mg	1	10	60	$780	$2.1M
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.	187	320	6,160	$120	$2.1M
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.	136	280	2,690	$130	$1.6M
J0401	Injection, aripiprazole (abilify maintena), 1 mg	1	10	1,040	$850	$882.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	345	360	1,830	$40	$819.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	5	90	4,210	$30	$676.8K
0241U	N/A	119	140	1,140	$150	$510.8K

Showing 1–10 of 57

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolinas Medical Center	NC	General Acute Care Hospital	$0	$178.2M
Carolinas Medical Center	NC	Surgical Critical Care Physician	$0	$52.9M
Carolinas Physicians Network Inc	NC	Psychologist	$0	$29.4M
Carolinas Medical Center	NC	Pediatrics Physician	$0	$17.8M
Carolinas Medical Center	NC	Ambulance	$0	$17M
Carolinas Medical Center	NC	General Practice Physician	$0	$16.6M
Carolinas Medical Center	NC	Child & Adolescent Psychiatry Physician	$0	$16.6M
Carolinas Medical Center	NC	Obstetrics & Gynecology Physician	$0	$11.8M
Carolinas Physicians Network Inc.	NC	Vascular Surgery Physician	$0	$8.9M
University Pediatrics	NC	Pediatrics Physician	$0	$8.1M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alexander Youth Network	NC	Community/Behavioral Health Agency	$0	$36.8M
David H. Moore, Dds,ms,pa	NC	Pediatric Dentistry	$0	$32M
Mid-atlantic Emergency Medical Associates, PLLC	NC	Emergency Medicine Physician	$0	$25.2M
Thompson Child And Family Focus	NC	Community/Behavioral Health Agency	$0	$24.1M
Mecklenburg County	NC	State or Local Public Health Clinic/Center	$0	$22.4M
Novant Health Medical Group LLC	NC	Pediatrics Physician	$0	$20.4M
Cooke And Mvula, PLLC	NC	Pediatric Dentistry	$0	$18.8M
Cotswold Family Medicine	NC	Family Medicine Physician	$0	$12.2M
Thompson Child And Family Focus	NC	Community/Behavioral Health Agency	$0	$10M
Mecklenburg County	NC	Case Management Agency	$0	$7.2M

Carolinas Medical Center — Billing Profile & Reimbursement Data

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Carolinas 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