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 South Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South 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. South 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.

Eastern Carolina Pediatric Associates PC (NPI 1437219979)

Field	Value
Entity Type	Organization
Organization	Eastern Carolina Pediatric Associates PC
Address	105 Industrial Way
City	Darlington
State	SC
ZIP	29532
Taxonomy	Pediatrics Physician
NPI Enumerated	December 12, 2006

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	33,580	$60	$2M
T1015	Clinic visit/encounter, all-inclusive	10,760	$90	$957.5K
99392	Preventive 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…	4,080	$80	$313.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,790	$90	$239.6K
99391	Preventive 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…	2,930	$80	$222.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,160	$100	$205.5K
90460	In 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.	4,820	$40	$192.9K
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…	1,240	$90	$106.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	3,660	$20	$54.9K
99188	The provider applies a fluoride adhesive over the tooth surface to prevent tooth decay, provide remineralization, or treat hypersensitivity.	3,140	$20	$47.1K

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Carolina Distribution

Eastern Carolina Pediatric Associates PC — 1 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

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

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	101	350	3,560	$30	$525.5K
99391	Preventive 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…	72	280	600	$90	$299K
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…	67	2,770	210	$60	$254.5K
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…	817	2,480	350	$80	$246K
99392	Preventive 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…	56	380	160	$100	$226.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	54	390	100	$100	$148.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	48	340	110	$110	$107.9K
90460	In 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.	96	650	140	$30	$98.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	240	270	120	$50	$93.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	81	240	280	$50	$78.4K

Showing 1–10 of 38

Related Providers

Other providers that share a Tax Identification Number (TIN) with Eastern Carolina Pediatric Associates PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Carolina Pediatric Associates	SC	Pediatrics Physician	$0	$15.3M
Eastern Carolina Pediatric Associates	SC	Pediatric Dentistry	$0	$7.2M

Nearby Providers

Other providers in the same ZIP code as Eastern Carolina Pediatric Associates PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Noc Home Care, LLC	SC	Nursing Care Agency	$0	$6M
Genesis Healthcare, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$3.3M
Darlington County Ems	SC	Land Ambulance	$988.4K	$1.8M
Darlington County School District	SC	Local Education Agency (LEA)	$0	$2.4M
Mcleod Physician Associates Ii	SC	Urgent Care Clinic/Center	$0	$2.3M
Pee Dee Professional Intervention Services, LLC	SC	Early Intervention Provider Agency	$0	$1.8M
Medone Medical Transport, LLC	SC	Land Ambulance	$583.1K	$13.1K
Medic Of South Carolina, LLC	SC	Land Ambulance	$281.5K	$109K
Delori Knight	SC	Speech-Language Pathologist	$49.3K	$156.6K
Vinay Jagadeesha	SC	Family Medicine Physician	$198K	$2.4K

Eastern Carolina Pediatric Associates PC — Billing Profile & Reimbursement Data

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Eastern Carolina Pediatric Associates PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References