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.

Private Diagnostic Clinic, PLLC (NPI 1447306113)

Private Diagnostic Clinic, PLLC is a pediatrics physician provider located in Durham, North Carolina. This profile covers 0 Medicare and 85 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Private Diagnostic Clinic, PLLC
Address	4020 N Roxboro St
City	Durham
State	NC
ZIP	27704
Taxonomy	Pediatrics Physician
NPI Enumerated	January 26, 2007

Payer Source	Total Paid
Medicaid	$17.5M
Medicare	$0

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

85 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.	480,370	$10	$2.9M
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…	26,760	$90	$2.3M
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.	50,830	$40	$1.9M
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…	31,060	$60	$1.9M
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…	18,490	$80	$1.5M
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…	16,900	$90	$1.5M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	12,490	$90	$1.1M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	10,430	$80	$875.7K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	9,720	$70	$689.8K
96110	The 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…	34,650	$10	$311.9K

Showing 1–10 of 85

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

Private Diagnostic Clinic, PLLC — 13 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

85 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	306	320	6,160	$120	$2.1M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	61	2,850	10,910	$10	$330.3K
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…	1,388	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…	116	4,400	960	$60	$271.3K
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…	14	520	1,080	$80	$262.1K
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…	17	550	970	$90	$258.9K
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…	124	4,130	670	$50	$219.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	141	340	260	$60	$187.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	18	590	490	$90	$179.8K
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.	3	380	460	$40	$173.1K

Showing 1–10 of 85

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergeortho PA	NC	Orthopaedic Surgery Physician	$0	$20.9M
Sunrise Clinical Associates, PLLC	NC	Community/Behavioral Health Agency	$0	$16.5M
County Of Durham Finance Dept	NC	Land Ambulance	$2.4M	$11.3M
Rapha Healthcare Services,llc	NC	Multi-Specialty Clinic/Center	$0	$13.6M
Php Of Nc, Inc	NC	Developmentally Disabled Services Day Training Agency	$0	$12.7M
Bayada Home Health, Care, Inc.	NC	Home Health Agency	$0	$11.6M
Duke University Health System, Inc.	NC	General Acute Care Hospital	$0	$11.6M
Duke University Health System, Inc.	NC	Parenteral & Enteral Nutrition Supplies (DME)	$0	$8.3M
Duke University Health System, Inc.	NC	Internal Medicine Physician	$0	$7.6M
Associated Health Services, Inc.	NC	Ambulatory Surgical Clinic/Center	$1.6M	$102.4K

Private Diagnostic Clinic, PLLC — Billing Profile & Reimbursement Data

Sign up for Private Diagnostic Clinic, PLLC — Billing Profile & Reimbursement Data policy alerts

Private Diagnostic Clinic, PLLC — Billing Profile & Reimbursement Data

Sign up for Private Diagnostic Clinic, PLLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References