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.

Carolinas Physicians Network Inc (NPI 1245759166)

Carolinas Physicians Network Inc is a pediatrics physician provider located in Concord, North Carolina. This profile covers 0 Medicare and 56 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	66 Lake Concord Rd Ne
City	Concord
State	NC
ZIP	28025
Taxonomy	Pediatrics Physician
NPI Enumerated	September 12, 2017

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

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

56 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…	61,010	$60	$3.7M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	296,460	$10	$1.5M
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…	10,680	$80	$886.8K
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…	9,410	$90	$856.7K
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…	8,240	$90	$741.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,420	$90	$571.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	14,420	$40	$504.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	24,730	$20	$445.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,440	$90	$212.1K
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.	3,360	$50	$158K

Showing 1–10 of 56

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

Carolinas Physicians Network Inc — 5 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

56 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	109	2,850	10,910	$10	$330.3K
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…	477	4,400	960	$60	$271.3K
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…	39	520	1,080	$80	$262.1K
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…	51	550	970	$90	$258.9K
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…	46	4,130	670	$50	$219.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	53	590	490	$90	$179.8K
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.	88	380	460	$40	$173.1K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	239	330	300	$10	$142.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	90	530	270	$90	$112.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	31	630	840	$30	$101.2K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Charlotte-mecklenburg Hospital Authority	NC	General Acute Care Hospital	$0	$56.5M
What Matters Most	NC	Community/Behavioral Health Agency	$0	$37.8M
Eventus Wholehealth, PLLC	NC	Family Medicine Physician	$0	$26.6M
Walkers Home Care	NC	Case Management Agency	$0	$23.3M
Greater Home Health Services LLC	NC	Nursing Care Agency	$0	$13.6M
Mcleod Centers For Wellbeing	NC	Community/Behavioral Health Agency	$91.3K	$11.4M
Community Specialized Services, Inc.	NC	Foster Care Agency	$0	$9.2M
Epiphany Family Services, LLC	NC	Community/Behavioral Health Agency	$0	$8.7M
The Charlotte-mecklenburg Hospital Authority	NC	Pediatrics Physician	$0	$8.1M
Gateway Ambulatory Surgery Center, LLC	NC	Clinic/Center	$1.3M	$2.7M

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

Related Providers

Nearby Providers

Frequently Asked Questions

References

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	Vascular Surgery Physician	$0	$8.9M
Carolinas Physicians Network Inc	SC	Pediatrics Physician	$0	$8.5M
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