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.

Rex Hospital Inc. (NPI 1497797088)

Field	Value
Entity Type	Organization
Organization	Rex Hospital Inc.
Address	4420 Lake Boone Trl
City	Raleigh
State	NC
ZIP	27607
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 11, 2006

Payer Source	Total Paid
Medicaid	$25.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

216 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.	19,190	$300	$5.7M
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.	25,540	$200	$5.2M
0241U	N/A	7,200	$160	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	28,060	$30	$729.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	28,040	$30	$729K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	70,000	$10	$630K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	9,970	$60	$578.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	79,110	$10	$553.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	36,030	$10	$504.4K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	16,380	$30	$491.3K

Showing 1–10 of 216

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

Rex Hospital Inc. — 5 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

216 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.	95	330	6,130	$130	$2.7M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	14	30	170	$260	$2.6M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	21	160	840	$70	$2.3M
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.	70	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.	170	280	2,690	$130	$1.6M
86003	The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…	4	40	220	$60	$920.5K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	15	70	280	$20	$896.7K
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.	194	360	1,830	$40	$819.8K
87507	The lab analyst performs a test to detect 12 to 25 types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that affects the gastrointestinal…	7	10	250	$160	$731K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	32	90	4,210	$30	$676.8K

Showing 1–10 of 216

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rex Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of North Carolina At Chapel Hill	NC	Anesthesiology Physician	$0	$87.6M
University Of North Carolina Hospitals At Chapel Hill	NC	General Acute Care Hospital	$0	$50.7M
Unc Physicians Network LLC	NC	General Practice Physician	$0	$47M
Caldwell Memorial Hospital, Inc.	NC	General Acute Care Hospital	$0	$28.8M
Unc Rockingham Health Care, Inc.	NC	General Acute Care Hospital	$0	$10.3M
University Of North Carolina Hospitals At Chapel Hill	NC	Durable Medical Equipment & Medical Supplies	$0	$7.8M
Caldwell Memorial Hospital, Inc	NC	Pediatrics Physician	$0	$7.3M
John Deans	NC	Ophthalmology Physician	$2.4M	$0
Rex Hospital, Inc.	NC	Land Ambulance	$1M	$204K
Orthopaedic Surgery Center Of Raleigh LLC	NC	Orthopaedic Surgery Physician	$1.1M	$0

Nearby Providers

Other providers in the same ZIP code as Rex Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Autism Society Of North Carolina, Inc.	NC	Community/Behavioral Health Agency	$0	$95.7M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$24.8M
Nc Dept Of Health And Human Service	NC	Clinical Medical Laboratory	$0	$16.4M
Jeffers Mann & Artman Pediatric & Adolesent Medicine PA	NC	Pediatric Adolescent Medicine Physician	$0	$10.9M
Pediatric Therapy Associates	NC	Physical Therapist	$0	$10.2M
Blue Ridge Day Surgery Center, LP	NC	Ambulatory Surgical Clinic/Center	$1.6M	$2.2M
John Thordsen	NC	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Rebecca Manning	NC	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Sachin Mudvari	NC	Retina Specialist (Ophthalmology) Physician	$3.2M	$0
Daniel Bennett	NC	Retina Specialist (Ophthalmology) Physician	$3M	$0

Rex Hospital Inc. — Billing Profile & Reimbursement Data

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Rex Hospital Inc. — 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