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    OpenPayerNPI Medicare & MedicaidCarolinas Medical Center
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    Carolinas Medical Center — Billing Profile & Reimbursement Data

    NPI 1326110909 · Charlotte, NC · General Practice Physician

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    Carolinas Medical Center is a general practice physician provider located in Charlotte, North Carolina. This profile covers 0 Medicare and 48 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationCarolinas Medical Center
    Address2001 Vail Ave
    CityCharlotte
    StateNC
    ZIP28207
    TaxonomyGeneral Practice Physician
    NPI EnumeratedNovember 15, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$16.6M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    48 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99392Preventive 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…50,830$80$4.1M
    99391Preventive 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…50,900$80$3.8M
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.27,910$80$2.3M
    90472This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.60,130$30$1.9M
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.90,460$20$1.5M
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.10,410$80$874.7K
    90460In 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.26,550$20$637.2K
    96110The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…62,700$10$501.6K
    90474In this procedure, the provider administers an additional live attenuated vaccine either via oral or intranasal route after the administration of the first vaccine.19,680$10$216.5K
    D0145N/A7,250$30$210.4K

    Showing 1–10 of 48

    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.

    Full comparison — all codes billed, vs. North Carolina median

    48 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient81904,210$30$676.8K
    99199Use this code to report other medicine services or procedures for which there is no specific code available.2,7712,85010,910$10$330.3K
    99391Preventive 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…15201,080$80$262.1K
    99392Preventive 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…1550970$90$258.9K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.2590490$90$179.8K
    90460In 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.15380460$40$173.1K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.6530270$90$112.8K
    90472This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.2630840$30$101.2K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients1391,250760$20$60K
    83655The lab analyst performs a test to measure the amount of lead in the patient specimen. A typical aim of the test is to check for lead exposure.8220240$10$50.1K

    Showing 1–10 of 48

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Carolinas Medical CenterNCGeneral Acute Care Hospital$0$178.2M
    Carolinas Medical CenterNCSurgical Critical Care Physician$0$52.9M
    Carolinas Physicians Network IncNCPsychologist$0$29.4M
    Carolinas Medical CenterNCPsychiatric Hospital Unit$0$20.6M
    Carolinas Medical CenterNCPediatrics Physician$0$17.8M
    Carolinas Medical CenterNCAmbulance$0$17M
    Carolinas Medical CenterNCChild & Adolescent Psychiatry Physician$0$16.6M
    Carolinas Medical CenterNCObstetrics & Gynecology Physician$0$11.8M
    Carolinas Physicians Network Inc.NCVascular Surgery Physician$0$8.9M
    University PediatricsNCPediatrics Physician$0$8.1M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    OrthocarolinaNCOrthopaedic Surgery Physician$0$12.3M
    Inpatient Consultants Of North Carolina, PCNCInternal Medicine Physician$0$12.1M
    Waveco LLCNCAmbulatory Surgical Clinic/Center$1.6M$0
    Andrew LasterNCRheumatology Physician$1.5M$0
    Justin FavaroNCHematology & Oncology Physician$1.2M$0
    Nasfat ShehadehNCHematology & Oncology Physician$700K$0
    Charlotte Gastroenterology & Hepatology, PLLCNCAmbulatory Surgical Clinic/Center$407.5K$90.2K
    Omar BeheryNCOrthopaedic Surgery Physician$446.2K$220
    Anthony KwonNCOrthopaedic Surgery Physician$371.3K$0
    Amit OmNCDermatology Physician$334.7K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. North Carolina Providers
    6 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    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