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.

Carolinas Physicians Network Inc (NPI 1235148529)

Carolinas Physicians Network Inc is a pediatrics physician provider located in Rock Hill, South Carolina. This profile covers 0 Medicare and 52 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	Carolinas Physicians Network Inc
Address	1656 Riverchase Blvd
City	Rock Hill
State	SC
ZIP	29732
Taxonomy	Pediatrics Physician
NPI Enumerated	August 5, 2006

Payer Source	Total Paid
Medicaid	$8.5M
Medicare	$0

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	33,300	$80	$2.8M
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…	35,870	$60	$2.1M
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…	12,560	$80	$979.7K
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…	9,820	$90	$834.7K
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.	28,620	$30	$744.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,810	$90	$338.9K
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…	10,180	$20	$203.5K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	14,460	$10	$115.6K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	11,700	$10	$93.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	860	$100	$84.4K

Showing 1–10 of 52

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

Carolinas Physicians Network Inc — 7 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

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	157	210	320	$130	$707.4K
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…	17	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…	58	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	384	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…	34	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…	20	380	160	$100	$226.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	35	390	100	$100	$148.3K
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…	40	110	130	$70	$134.7K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	65	170	500	$50	$128.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	84	340	110	$110	$107.9K

Showing 1–10 of 52

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolinas Physicians Network Inc	NC	Psychologist	$0	$29.4M
Cotswold Family Medicine	NC	Family Medicine Physician	$0	$12.2M
Carolinas Physicians Network Inc	NC	Pediatrics Physician	$0	$9.9M
Carolinas Physicians Network Inc.	NC	Vascular Surgery Physician	$0	$8.9M
Carolinas Physicians Network Inc	NC	Pediatrics Physician	$0	$8.5M
University Pediatrics	NC	Pediatrics Physician	$0	$8.1M
Carolinas Physician Network Inc	NC	Pediatrics Physician	$0	$7.7M
Carolinas Physicians Network Inc	NC	Pediatrics Physician	$0	$7.3M
Carolinas Physicians Network Inc	SC	Pediatrics Physician	$0	$3M
Floyd Physicians, LLC	GA	Neonatal-Perinatal Medicine Physician	$0	$2.6M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amisub Of South Carolina, Inc.	SC	General Acute Care Hospital	$0	$34.5M
New Horizons Homecare	SC	Community Based Hospice Care Agency	$0	$14.6M
Tri-county Pediatrics LLC	SC	Pediatrics Physician	$0	$13.8M
A Mother's Choice Home Healthcare Agency LLC	SC	In Home Supportive Care Agency	$0	$6.9M
Right Steps LLC	SC	Speech-Language Pathologist	$0	$5.3M
Southern Home Care Services, Inc.	SC	In Home Supportive Care Agency	$0	$4M
Addus Healthcare (south Carolina), Inc.	SC	In Home Supportive Care Agency	$0	$3.7M
Family Dental LLC	SC	General Practice Dentistry	$0	$3.5M
Rock Hill Surgery Center, LLC	SC	Ambulatory Surgical Clinic/Center	$1.3M	$1.7M
Keystone Behavioral Health	SC	Community/Behavioral Health Agency	$0	$3M

Carolinas Physicians Network Inc — Billing Profile & Reimbursement Data

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Carolinas Physicians Network 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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