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 Medical Center (NPI 1295789907)

Field	Value
Entity Type	Organization
Organization	Carolinas Medical Center
Address	1000 Blythe Blvd
City	Charlotte
State	NC
ZIP	28203
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$178.2M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $178.2M in total Medicaid revenue, meaning its documented public-repayer footprint is effectively concentrated in Medicaid rather than split across Medicare and Medicaid. Analysts should treat CAROLINAS MEDICAL CENTER as a Medicaid-dominant billing entity for the available data set.

Revenue is highly concentrated: the precomputed top-3 Medicaid codes by revenue account for 56.5% of the provider's total Medicaid revenue. Those top drivers are 99283 ($39.5M, 27.1%), 99284 ($28.3M, 19.4%), and G0463 ($14.6M, 10.0%), indicating a small set of codes produces the majority of reported Medicaid dollars.

The code mix strongly indicates a high-volume emergency department and hospital outpatient clinic operation: 99283 has 97.3K claims, 99284 has 73.5K claims, and G0463 has 539K claims. Together with observation services (G0378, 8.3K claims) and frequent ED code 99285 (27.3K claims), the pattern is consistent with large-scale ED throughput and substantial ambulatory clinic encounters billed to Medicaid.

CAROLINAS MEDICAL CENTER ranks as a statewide high-volume competitor on core outpatient/ED and clinic codes: 99283 ranks #9 of 316 providers in-state (97th percentile) and 99284 ranks #17 of 325 (95th percentile), while G0463 ranks #1 of 86 providers (100th percentile, described as an extreme outlier). These rankings indicate the provider is among the dominant in-state performers for ED and hospital outpatient clinic visits.

Lab and infectious-disease testing volumes are substantial and concentrated in outpatient throughput: U0003 shows 78.5K claims ($7.1M), 87491 has 115K claims ($3.6M), 87591 has 114.1K claims ($3M), 80053 has 133.4K claims ($5.1M), and 85025 has 145.5K claims ($1.2M). The scale and mix — including multiplex respiratory testing 87636 (15.5K claims) — reinforce that the provider operates a large outpatient testing and specimen-collection platform tied to its clinic and ED volumes.

Medication administration and in-hospital drug billing are meaningful revenue contributors: J3490 appears with 130.7K claims and $7.1M revenue (rank #7 of 158, notably above typical state volume), J1642 shows $4.8M revenue (8.5K claims, rank #2 of 35), and J8499 is an extreme outlier at rank #1 of 38 with 55.2K claims and $1.3M revenue. These entries point to significant onsite drug administration and miscellaneous drug coding activity in the Medicaid population.

Specialty infusion and oncology-related services are a notable part of the service mix: 96413 (chemotherapy) reports 8K claims and $2.5M revenue and ranks #3 of 64 providers (97th percentile; extreme outlier), while 36591 (access device blood draw) is ranked #1 of 23 (100th percentile) with $937.1K revenue. Together these data suggest the hospital supports an active oncology/infusion program with associated access-device utilization.

The provider has long tenure in the NPI registry (NPI enumerated 2006-05-19 (~20 years ago)), and the combination of long-established status plus very large claim counts and multiple 98–100th percentile rankings supports characterization as a major regional hospital system within North Carolina's Medicaid landscape rather than a small or transient clinic-level participant.

Medicaid: Complete Services Breakdown

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

441 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	97,300	$410	$39.5M
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.	73,530	$390	$28.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	538,950	$30	$14.6M
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.	27,300	$300	$8.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	78,510	$90	$7.1M
J3490	Unclassified drugs	130,700	$50	$7.1M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	133,420	$40	$5.1M
J1642	Injection, heparin sodium, (heparin lock flush), per 10 units	8,520	$560	$4.8M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	3,660	$1,130	$4.2M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	115,010	$30	$3.6M

Showing 1–10 of 441

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 Medical Center — 16 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

441 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	9	20	240	$400	$13.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3	10	110	$5,750	$3.2M
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.	17	330	6,130	$130	$2.7M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	13	30	170	$260	$2.6M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	8	160	840	$70	$2.3M
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.	9	320	6,160	$120	$2.1M
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.	33	280	2,690	$130	$1.6M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	5	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…	27	80	420	$30	$1.2M
86003	The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…	22	40	220	$60	$920.5K

Showing 1–10 of 441

Related Providers

Other providers that share a Tax Identification Number (TIN) with Carolinas Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolinas Medical Center	NC	Surgical Critical Care Physician	$0	$52.9M
Carolinas Physicians Network Inc	NC	Psychologist	$0	$29.4M
Carolinas Medical Center	NC	Psychiatric Hospital Unit	$0	$20.6M
Carolinas Medical Center	NC	Pediatrics Physician	$0	$17.8M
Carolinas Medical Center	NC	Ambulance	$0	$17M
Carolinas Medical Center	NC	General Practice Physician	$0	$16.6M
Carolinas Medical Center	NC	Child & Adolescent Psychiatry Physician	$0	$16.6M
Carolinas Medical Center	NC	Obstetrics & Gynecology Physician	$0	$11.8M
Carolinas Physicians Network Inc.	NC	Vascular Surgery Physician	$0	$8.9M
University Pediatrics	NC	Pediatrics Physician	$0	$8.1M

Nearby Providers

Other providers in the same ZIP code as Carolinas Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cross River Nc	NC	Behavior Analyst	$0	$34.8M
Boris Krivitsky	NC	Hospice and Palliative Medicine (Internal Medicine) Physician	$1.3M	$0
Michael Morgan	NC	Rheumatology Physician	$352.2K	$0
Euphemia Mu	NC	MOHS-Micrographic Surgery Physician	$335K	$0
Matthew Leonard	NC	Emergency Medicine Physician	$191.6K	$0
Thanigaiarsu Thiyagarajan	NC	Internal Medicine Physician	$191.3K	$0
Puneet Aggarwal	NC	Physical Medicine & Rehabilitation Physician	$175.1K	$0
Muhammad Rashad	NC	Pulmonary Disease Physician	$161.9K	$0
Keith Kaplan	NC	Anatomic Pathology & Clinical Pathology Physician	$74.6K	$65.2K
Chad Mccall	NC	Anatomic Pathology & Clinical Pathology Physician	$136.4K	$0

Carolinas Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References