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.

Caldwell Memorial Hospital, Inc. (NPI 1114974029)

Field	Value
Entity Type	Organization
Organization	Caldwell Memorial Hospital, Inc.
Address	321 Mulberry Street, Sw
City	Lenoir
State	NC
ZIP	28645
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$28.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

189 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	287,760	$30	$7.5M
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.	27,870	$190	$5.4M
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.	16,940	$210	$3.5M
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	39,940	$70	$2.6M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	12,810	$90	$1.1M
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.	4,850	$220	$1.1M
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	22,720	$40	$931.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	42,070	$20	$673.1K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	870	$720	$628.1K
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.	25,720	$20	$514.3K

Showing 1–10 of 189

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

Caldwell Memorial Hospital, Inc. — 8 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

189 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	108	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…	108	160	840	$70	$2.3M
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.	62	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.	118	280	2,690	$130	$1.6M
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.	206	360	1,830	$40	$819.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	2	90	4,210	$30	$676.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	161	190	530	$20	$635.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	162	190	560	$20	$609.8K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	86	150	860	$50	$586.6K
0241U	N/A	63	140	1,140	$150	$510.8K

Showing 1–10 of 189

Related Providers

Other providers that share a Tax Identification Number (TIN) with Caldwell Memorial Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of North Carolina At Chapel Hill	NC	Anesthesiology Physician	$0	$87.6M
University Of North Carolina Hospitals At Chapel Hill	NC	General Acute Care Hospital	$0	$50.7M
Unc Physicians Network LLC	NC	General Practice Physician	$0	$47M
Rex Hospital Inc.	NC	General Acute Care Hospital	$0	$25.3M
Unc Rockingham Health Care, Inc.	NC	General Acute Care Hospital	$0	$10.3M
University Of North Carolina Hospitals At Chapel Hill	NC	Durable Medical Equipment & Medical Supplies	$0	$7.8M
Caldwell Memorial Hospital, Inc	NC	Pediatrics Physician	$0	$7.3M
John Deans	NC	Ophthalmology Physician	$2.4M	$0
Rex Hospital, Inc.	NC	Land Ambulance	$1M	$204K
Orthopaedic Surgery Center Of Raleigh LLC	NC	Orthopaedic Surgery Physician	$1.1M	$0

Nearby Providers

Other providers in the same ZIP code as Caldwell Memorial Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Universal Mental Health Services, Inc.	NC	Community/Behavioral Health Agency	$0	$158.1M
Et Care Inc	NC	Durable Medical Equipment & Medical Supplies	$0	$35.6M
Rha Health Services, In	NC	Community/Behavioral Health Agency	$0	$10.9M
Comserv, Inc.	NC	Community/Behavioral Health Agency	$0	$9.8M
Mcleod Centers For Wellbeing	NC	Community/Behavioral Health Agency	$0	$8M
County Of Caldwell	NC	Ambulance	$764.2K	$2.3M
Johnny Dy	NC	Cardiovascular Disease Physician	$524.4K	$0
Meredith Dickson	NC	Foot & Ankle Surgery Podiatrist	$172.7K	$0
Kent Edwards	NC	Urology Physician	$136.3K	$0
Jenyung Chiu	NC	Interventional Cardiology Physician	$110.1K	$0

Caldwell Memorial Hospital, Inc. — Billing Profile & Reimbursement Data

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Caldwell Memorial Hospital, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References