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 Emergency Physicians, P.A. (NPI 1316264195)

Field	Value
Entity Type	Organization
Organization	Carolinas Emergency Physicians, P.A.
Address	201 E Grover St
City	Shelby
State	NC
ZIP	28150
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 3, 2010

Payer Source	Total Paid
Medicaid	$9.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	58,550	$70	$3.9M
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.	39,640	$80	$3.3M
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.	42,810	$40	$1.7M
99053	The provider renders overnight services at a 24 hour facility.	9,110	$10	$63.8K
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…	560	$100	$55.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	17,040	$1	$51.1K
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.	320	$30	$8.6K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	20	$1	$20
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	40	$0	$0

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 Emergency Physicians, P.A. — 1 of 8 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	27	330	6,130	$130	$2.7M
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.	37	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.	20	280	2,690	$130	$1.6M
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.	113	150	1,340	$80	$395.9K
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…	41	140	150	$120	$128.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	33	240	1,280	$1	$33.1K
99053	The provider renders overnight services at a 24 hour facility.	2	30	120	$1	$7.9K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	315	340	180	$10	$7.5K
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	4	10	280	$0	$0

Nearby Providers

Other providers in the same ZIP code as Carolinas Emergency Physicians, P.A., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Charlotte-mecklenburg Hospital Authority	NC	General Acute Care Hospital	$0	$58.1M
Carolinas Physicians Network Inc	NC	Psychologist	$0	$29.4M
One On One Care Inc	NC	Community/Behavioral Health Agency	$0	$18.4M
Webb Orthodontics	NC	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$13.9M
Cleveland Vocational Industries, Inc.	NC	Community/Behavioral Health Agency	$0	$10.2M
Life Enrichment Center Of Cleveland County, Inc.	NC	Adult Day Care Clinic/Center	$0	$9.9M
Families First Support Services, LLC	NC	Community/Behavioral Health Agency	$0	$7.4M
County Of Cleveland North Carolina	NC	Land Ambulance	$1.4M	$5.7M
Cleveland Ambulatory Services, LLC	NC	Ambulatory Surgical Clinic/Center	$304.1K	$798.9K
Morganton Eye Physicians, P.A.	NC	Ambulatory Surgical Clinic/Center	$695.7K	$255K

Carolinas Emergency Physicians, P.A. — Billing Profile & Reimbursement Data

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Carolinas Emergency Physicians, P.A. — 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