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.

Coastal Southeastern United Care LLC (NPI 1346477403)

Field	Value
Entity Type	Organization
Organization	Coastal Southeastern United Care LLC
Address	10 Doctors Circle
City	Supply
State	NC
ZIP	28462
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	June 16, 2009

Payer Source	Total Paid
Medicaid	$46.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and the organization reports $46.6M in lifetime Medicaid revenue, indicating that Medicaid is the dominant and near‑exclusive funding source for its services. Analysts should treat this entity as Medicaid‑dependent when evaluating payer risk and contracting exposure.

Revenue is highly concentrated in a few programmatic codes: the top three Medicaid codes account for 82.6% of the provider’s Medicaid revenue. H0040 drives the majority with $29.1M (62.4%), followed by H2022 with $5.3M (11.4%) and H0038 with $4.1M (8.9%), signaling that a small number of service lines produce most of the cashflow.

The code mix strongly reflects an intensive community behavioral health operating model: H0040 is an assertive community treatment per‑diem, H2022 is community‑based wrap‑around per‑diem, and H0038 is self‑help/peer services billed in 15‑minute increments. This combination indicates the provider runs programmatic, per‑diem and time‑based community supports rather than a traditional fee‑for‑visit outpatient clinic as its core revenue engine.

Competitive standing is extreme for the top program code: the provider ranks #1 of 119 in the state for H0040 (100th percentile; extreme outlier), making it a dominant statewide provider for assertive community treatment. By contrast, H2022 (rank #34 of 216, 85th percentile) and H0038 (rank #20 of 309, 94th percentile) are high‑volume but less singularly dominant, reflecting leadership in some program lines and strong but not unique volume in others.

Despite H0040’s dominance, the provider also shows concentrated high relative activity in targeted clinical services: 90791 (psychiatric evaluation) is an outlier at rank #13 of 866 (99th percentile; extreme outlier) even though it represents a smaller share of revenue ($310K, 0.7%). This suggests a notable throughput of diagnostic psychiatric evaluations alongside programmatic per‑diem services.

The organization has a long tenure in the marketplace, with its NPI enumerated on 2009-06-16 (~17 years ago). That longevity, combined with concentrated program billing, implies established operational infrastructure to support large per‑diem community programs.

Concentration in a few Medicaid program codes creates operational and reimbursement exposure: because 82.6% of Medicaid revenue comes from three codes, any changes in Medicaid per‑diem rates, program eligibility, or contracting for H0040/H2022 could materially affect the provider’s financials. Analysts should flag this as a single‑program risk in contracting or utilization management scenarios.

The provider’s billing footprint includes traditional outpatient E/M and telehealth elements (e.g., 99213, 99214, Q3014) but these are small relative to program revenue (99213 $639.9K; Q3014 $7.3K). This pattern indicates a blended service delivery model where clinic visits and telehealth exist but are secondary to large per‑diem community treatment programs.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0040	Assertive community treatment program, per diem	129,700	$220	$29.1M
H2022	Community-based wrap-around services, per diem	23,400	$230	$5.3M
H0038	Self‑help/peer services, per 15 minutes	41,210	$100	$4.1M
H2015	Comprehensive community support services, per 15 minutes	20,640	$150	$3.1M
T1017	Targeted case management, each 15 minutes	5,160	$260	$1.3M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	17,180	$60	$1.1M
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…	14,880	$40	$639.9K
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…	7,070	$70	$466.3K
H2023	Supported employment, per 15 minutes	2,640	$140	$364.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	3,480	$90	$310K

Showing 1–10 of 22

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

Coastal Southeastern United Care LLC — 3 of 21 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	1	120	15,180	$230	$5M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	93	90	45,620	$40	$3.5M
H2022	Community-based wrap-around services, per diem	34	220	3,330	$290	$3.3M
H2015	Comprehensive community support services, per 15 minutes	75	250	10,060	$130	$2.4M
H0038	Self‑help/peer services, per 15 minutes	20	310	2,820	$120	$1.3M
T1017	Targeted case management, each 15 minutes	44	220	1,700	$150	$1.3M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	49	360	1,830	$40	$819.8K
H2023	Supported employment, per 15 minutes	29	70	1,950	$150	$679.8K
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…	514	1,710	810	$80	$274.5K
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…	645	4,400	960	$60	$271.3K

Showing 1–10 of 22

Nearby Providers

Other providers in the same ZIP code as Coastal Southeastern United Care LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Renee Shepherd-smith	NC	Foot & Ankle Surgery Podiatrist	$859.7K	$0
Kenneth Willeford	NC	Physical Medicine & Rehabilitation Physician	$351.2K	$0
Novant Health Brunswick Endoscopy Center, LLC	NC	Ambulatory Surgical Clinic/Center	$339.7K	$0
Paula Reyes	NC	Physician Assistant	$338.7K	$0
Richard Leighton	NC	Orthopaedic Surgery Physician	$288.2K	$0
Richard Crane	NC	Internal Medicine Physician	$276.5K	$0
Kevin Cahill	NC	Neurological Surgery Physician	$159.2K	$0
Allan Andrews	NC	Gastroenterology Physician	$157K	$0
Joseph Kibler	NC	Primary Podiatric Medicine Podiatrist	$64.8K	$0
Kimberly Palmer	NC	Clinical Social Worker	$1.7K	$0

Coastal Southeastern United Care LLC — Billing Profile & Reimbursement Data

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Coastal Southeastern United Care LLC — 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

Nearby Providers

Frequently Asked Questions

References