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.

Carolina Family Care, Inc (NPI 1093076457)

Carolina Family Care, Inc is a family medicine physician provider located in Florence, South Carolina. This profile covers 0 Medicare and 72 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	Carolina Family Care, Inc
Address	805 Pamplico Hwy
City	Florence
State	SC
ZIP	29505
Taxonomy	Family Medicine Physician
NPI Enumerated	June 1, 2012

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

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

72 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…	30,450	$50	$1.5M
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…	24,470	$60	$1.4M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,270	$90	$204.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,940	$100	$185.8K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	6,420	$20	$115.6K
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…	1,390	$70	$90.6K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	4,360	$20	$78.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	700	$100	$66.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	610	$110	$64K
T1015	Clinic visit/encounter, all-inclusive	460	$110	$48.3K

Showing 1–10 of 72

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

Carolina Family Care, Inc — 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

72 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	123	210	1,470	$60	$615K
T1015	Clinic visit/encounter, all-inclusive	295	350	3,560	$30	$525.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	82	280	600	$90	$299K
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…	79	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	90	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…	52	2,480	350	$80	$246K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	95	380	160	$100	$226.8K
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…	140	410	330	$50	$152.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	122	390	100	$100	$148.3K
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…	192	230	430	$40	$129.9K

Showing 1–10 of 72

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolina Family Care, Inc	SC	Internal Medicine Physician	$0	$6.9M
Medical University Hospital Authority	SC	Rural Health Clinic/Center	$0	$4.5M
Carolina Family Care, Inc	SC	Clinical Medical Laboratory	$1.8M	$1.3M
David Sosnouski	IA	Diagnostic Radiology Physician	$592.7K	$0
Jason Snyder	SC	Diagnostic Radiology Physician	$270.9K	$0
Russell Chapin	SC	Diagnostic Radiology Physician	$249.5K	$0
Abdallah Kamouh	SC	Interventional Cardiology Physician	$241.8K	$0
Kathy Bolus	SC	Internal Medicine Physician	$238.3K	$0
Andrew Hardie	SC	Diagnostic Radiology Physician	$227.1K	$0
Misty Seawright	SC	Nurse Practitioner	$217.6K	$5.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$28.3M
Eastern Carolina Pediatric Associates	SC	Pediatrics Physician	$0	$15.3M
Amedisys Hospice, L.L.C.	SC	Community Based Hospice Care Agency	$0	$14.1M
New Generations Adult Day Center, Inc.	SC	Adult Care Home Facility	$0	$6.9M
Pee Dee Pediatric Dentistry	SC	Pediatric Dentistry	$0	$6.4M
Qhg Of South Carolina Inc	SC	General Acute Care Hospital	$0	$5.4M
Florence Treatment Specialists LLC	SC	Methadone Clinic	$5.5K	$2.1M
Cw Counseling And Consulting, LLC	SC	Clinical Social Worker	$0	$1.8M
Pee Dee Pathology Associates Inc.	SC	Clinical Medical Laboratory	$521.7K	$220.7K
Heartline Transport Services, LLC	SC	Land Ambulance	$521.9K	$0

Carolina Family Care, Inc — Billing Profile & Reimbursement Data

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Carolina Family Care, 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

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