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.

Denise Carneiro-pla (NPI 1144344805)

Field	Value
Entity Type	Individual
Organization	Denise Carneiro-pla
Address	171 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	Surgery Physician
NPI Enumerated	March 19, 2007

Payer Source	Total Paid
Medicare	$69.7K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
60500	In the traditional procedure of parathyroid exploration, the provider surgically visualizes and screens the parathyroid glands for pathology based on their appearance and relative size. He may then…	60	$710	$41.7K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	90	$140	$13.5K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	150	$50	$6.9K
60220	This is a procedure involving complete surgical removal of one of the two lobes the thyroid gland is divided into. The provider may perform the procedure with or without surgical removal of the…	10	$470	$5.1K
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…	20	$70	$1.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	10	$110	$1.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Denise Carneiro-pla — 1 of 6 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. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
60500	1	10	30	$870	$27K
99214	7,469	7,860	160	$80	$23.2K
99215	2,297	2,360	40	$120	$9.3K
99205	68	1,000	30	$150	$5.8K
60220	1	10	10	$470	$5.1K
76536	14	260	30	$40	$2.2K

Denise Carneiro-pla — Billing Profile & Reimbursement Data

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Denise Carneiro-pla — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References