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.

Carolina Family Care, Inc (NPI 1275564098)

Carolina Family Care, Inc is a internal medicine physician provider located in Lancaster, South Carolina. This profile covers 0 Medicare and 93 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	Carolina Family Care, Inc
Address	201 W Meeting St
City	Lancaster
State	SC
ZIP	29720
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 6, 2006

Payer Source	Total Paid
Medicaid	$6.9M
Medicare	$0

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

93 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…	33,070	$50	$1.5M
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.	22,370	$50	$1M
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.	12,040	$80	$939.1K
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…	15,400	$50	$754.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	16,570	$40	$579.8K
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.	2,160	$100	$207.1K
99203	The provider sees a new 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 provider…	3,390	$60	$207K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,600	$50	$187.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1,300	$120	$154.2K
99204	The provider sees a new 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 provider…	1,740	$80	$146.2K

Showing 1–10 of 93

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

Carolina Family Care, Inc — 4 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

93 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	51	340	110	$40	$450.5K
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.	69	350	100	$50	$446.9K
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.	93	200	1,680	$50	$443.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	100	140	2,520	$90	$415.3K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	26	60	50	$960	$381.4K
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…	70	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	96	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…	101	2,480	350	$80	$246K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	54	60	350	$190	$230.8K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	24	30	250	$360	$227.9K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical University Hospital Authority	SC	Rural Health Clinic/Center	$0	$4.5M
Carolina Family Care, Inc	SC	Family Medicine Physician	$0	$4.1M
Carolina Family Care, Inc	SC	Clinical Medical Laboratory	$1.8M	$1.3M
David Sosnouski	IA	Diagnostic Radiology Physician	$592.7K	$0
Jason Snyder	SC	Diagnostic Radiology Physician	$270.9K	$0
Russell Chapin	SC	Diagnostic Radiology Physician	$249.5K	$0
Abdallah Kamouh	SC	Interventional Cardiology Physician	$241.8K	$0
Kathy Bolus	SC	Internal Medicine Physician	$238.3K	$0
Andrew Hardie	SC	Diagnostic Radiology Physician	$227.1K	$0
Misty Seawright	SC	Nurse Practitioner	$217.6K	$5.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chester-lancaster Disabilties & Special Needs Board	SC	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$12.1M
The Children's Clinic	SC	Clinic/Center	$0	$8.4M
Golden Care Inc	SC	Home Health Agency	$0	$7.1M
Mante Pediatrics LLC	SC	Pediatrics Physician	$0	$7M
Morphis Pediatric Group Of Lancaster, P.A.	SC	Rural Health Clinic/Center	$0	$4.8M
Lancaster County School District	SC	Local Education Agency (LEA)	$0	$2.9M
Oscar Kuruvilla	SC	Ophthalmology Physician	$2.7M	$0
County Of Lancaster	SC	Land Ambulance	$963.3K	$1.5M
Lancaster Hospital Corporation	SC	General Acute Care Hospital	$0	$1.9M

Carolina Family Care, Inc — Billing Profile & Reimbursement Data

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Carolina Family Care, 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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