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.

Duplin General Hospital Incorporated (NPI 1508832833)

Duplin General Hospital Incorporated is a general acute care hospital provider located in Kenansville, North Carolina. This profile covers 0 Medicare and 93 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	Duplin General Hospital Incorporated
Address	401 North Main St
City	Kenansville
State	NC
ZIP	28349
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 27, 2006

Payer Source	Total Paid
Medicaid	$13.6M
Medicare	$0

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

93 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	32,210	$110	$3.5M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,180	$1,000	$2.2M
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.	17,590	$120	$2.2M
0241U	N/A	7,090	$170	$1.2M
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.	6,710	$120	$771.2K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	6,180	$80	$463.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	5,500	$70	$385K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,540	$200	$312.4K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	280	$920	$259.5K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	4,050	$60	$234.9K

Showing 1–10 of 93

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

Duplin General Hospital Incorporated — 1 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

93 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.	107	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…	19	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…	61	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.	50	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.	106	280	2,690	$130	$1.6M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2	40	420	$1,080	$841K
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.	201	360	1,830	$40	$819.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	65	90	4,210	$30	$676.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	122	190	530	$20	$635.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	122	190	560	$20	$609.8K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vidant Medical Group LLC	NC	Multi-Specialty Clinic/Center	$0	$78M
Pitt County Memorial Hospital, Inc	NC	General Acute Care Hospital	$0	$60.3M
East Carolina University	NC	Internal Medicine Physician	$0	$53.7M
Pitt County Memorial Hospital Inc	NC	Ambulance	$0	$15.6M
East Carolina Health - Heritage Inc	NC	General Acute Care Hospital	$0	$12.9M
East Carolina Health - Chowan Inc	NC	Critical Access Hospital	$0	$9.5M
East Carolina Health	NC	General Acute Care Hospital	$0	$8.2M
Surgicenter Of Eastern Carolina LLC	NC	Ambulatory Surgical Clinic/Center	$2.6M	$4.6M
Susan Andracchi	NC	Ophthalmology Physician	$1.9M	$0
Maria Picton	NC	Hematology & Oncology Physician	$1.4M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hunter C. Joh, Dds PA	NC	General Practice Dentistry	$0	$18.1M
County Of Duplin	NC	Land Ambulance	$798.6K	$2.3M

Duplin General Hospital Incorporated — Billing Profile & Reimbursement Data

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Duplin General Hospital Incorporated — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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