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.

Craven County (NPI 1295801827)

Field	Value
Entity Type	Organization
Organization	Craven County
Address	2818 Neuse Blvd
City	New Bern
State	NC
ZIP	28560
Taxonomy	State or Local Public Health Clinic/Center
NPI Enumerated	November 27, 2006

Payer Source	Total Paid
Medicaid	$10.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

147 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	577,760	$10	$2.9M
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…	21,570	$70	$1.4M
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…	17,350	$70	$1.2M
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	570	$770	$433.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	2,640	$120	$327.9K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	1,940	$160	$302.5K
D2392	Post 2 surface resin‑based composite	2,480	$110	$278.1K
D1120	Prophylaxis–child	9,000	$30	$270K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	1,940	$130	$244.2K
D0120	Periodic oral evaluation - established patient	7,090	$30	$205.6K

Showing 1–10 of 147

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

Craven County — 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

147 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,…	10	20	240	$400	$13.6M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	35	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.	35	190	560	$20	$609.8K
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…	18	100	400	$10	$440.2K
D2930	N/A	220	260	710	$140	$426.8K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	19	60	570	$20	$397.8K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	43	2,850	10,910	$10	$330.3K
82105	The lab analyst measures the quantitative level of the alpha–fetoprotein. This glycoprotein is produced early in fetal life, and a variety of tumors can also produce it later in life.	14	30	350	$10	$310.3K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	21	50	380	$10	$302.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	945	1,710	810	$80	$274.5K

Showing 1–10 of 147

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Towarnicky	NC	Internal Medicine Physician	$226.7K	$0
Jeremy Belch	NC	Obstetrics & Gynecology Physician	$33.9K	$0

Nearby Providers

Other providers in the same ZIP code as Craven County, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolinaeast Medical Center	NC	General Acute Care Hospital	$0	$22.9M
Human Resources Unlimited, Inc.	NC	Mental Health Counselor	$0	$7.3M
Craven County	NC	Land Ambulance	$632.1K	$1.5M
Scott Mcclellan	NC	Dermatopathology Physician	$1.5M	$0
Sean Murphy	NC	Dermatology Physician	$1.1M	$0
James Polo	NC	Dermatology Physician	$966.5K	$0
Mark Sinning	NC	Surgery Physician	$639.3K	$0
Brian Theune	NC	Surgery Physician	$434.6K	$0
Kirk Harum	NC	Pain Medicine (Anesthesiology) Physician	$337.9K	$790
Catherine Pollard	NC	Physician Assistant	$325.6K	$0

Craven County — Billing Profile & Reimbursement Data

Sign up for Craven County — Billing Profile & Reimbursement Data policy alerts

Craven County — Billing Profile & Reimbursement Data

Sign up for Craven County — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References