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.

Nc Dept Of Health And Human Service (NPI 1235290651)

Field	Value
Entity Type	Organization
Organization	Nc Dept Of Health And Human Service
Address	4312 District Dr
City	Raleigh
State	NC
ZIP	27607
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	December 12, 2006

Payer Source	Total Paid
Medicaid	$16.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

54 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	665,590	$10	$4.7M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	348,940	$10	$3.1M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	348,820	$10	$3.1M
83655	The lab analyst performs a test to measure the amount of lead in the patient specimen. A typical aim of the test is to check for lead exposure.	146,000	$10	$1.9M
86803	Qualitative or Semiquantitative Immunoassays; Hepatitis C antibody	131,910	$1	$527.6K
83020	The lab analyst records and calculates the hemoglobin fractions in a whole blood sample demonstrated by this hemoglobin fractionation test by electrophoresis.	33,680	$10	$404.2K
86762	The lab analyst performs an immunoassay to evaluate the patient’s serum for antibodies to rubella.	28,800	$10	$403.2K
87340	The lab analyst performs a test to detect hepatitis B surface antigen, also called HBsAg, using an immunoassay technique, such as EIA.	52,480	$10	$367.4K
86592	The lab analyst performs a test to detect the presence of syphilis–related antibodies in patient specimens using antigen tests such as rapid plasma reagin, called RPR; automated reagin test, called…	326,750	$1	$326.8K
86593	The lab analyst performs a test to evaluate the level of syphilis–related antibodies in patient specimens.	295,100	$1	$295.1K

Showing 1–10 of 54

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

Nc Dept Of Health And Human Service — 14 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

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	14	40	480	$40	$1.4M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	29	80	420	$30	$1.2M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	4	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.	4	190	560	$20	$609.8K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	17	80	750	$120	$449.7K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	2	100	400	$10	$440.2K
87529	The lab analyst performs a test for Herpes simplex virus, HSV, using amplified nucleic acid probe technique. HSV causes clusters of blisters, or vesicles, on different parts of the body and spreads…	2	20	370	$20	$254.5K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	77	210	290	$10	$187K
87521	A lab tests a patient’s specimen to provide a definitive diagnosis of hepatitis C by amplified probe technique.	2	10	2,470	$20	$154K
87535	A lab tests a patient’s specimen to provide a definitive diagnosis of HIV–1 by amplified probe technique.	6	10	620	$20	$120.9K

Showing 1–10 of 54

Nearby Providers

Other providers in the same ZIP code as Nc Dept Of Health And Human Service, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Autism Society Of North Carolina, Inc.	NC	Community/Behavioral Health Agency	$0	$95.7M
Rex Hospital Inc.	NC	General Acute Care Hospital	$0	$25.3M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$24.8M
Jeffers Mann & Artman Pediatric & Adolesent Medicine PA	NC	Pediatric Adolescent Medicine Physician	$0	$10.9M
Pediatric Therapy Associates	NC	Physical Therapist	$0	$10.2M
Blue Ridge Day Surgery Center, LP	NC	Ambulatory Surgical Clinic/Center	$1.6M	$2.2M
John Thordsen	NC	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Rebecca Manning	NC	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Sachin Mudvari	NC	Retina Specialist (Ophthalmology) Physician	$3.2M	$0
Daniel Bennett	NC	Retina Specialist (Ophthalmology) Physician	$3M	$0

Nc Dept Of Health And Human Service — Billing Profile & Reimbursement Data

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Nc Dept Of Health And Human Service — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References