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.

East Carolina University (NPI 1528016938)

East Carolina University is a obstetrics & gynecology physician provider located in Greenville, North Carolina. This profile covers 0 Medicare and 74 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	East Carolina University
Address	600 Moye Blvd
City	Greenville
State	NC
ZIP	27834
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	May 5, 2006

Payer Source	Total Paid
Medicaid	$12.3M
Medicare	$0

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

74 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	27,190	$80	$2.1M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	12,740	$140	$1.8M
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…	46,540	$40	$1.7M
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	15,810	$60	$980.2K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	24,990	$30	$699.6K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	76,520	$10	$535.6K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	12,920	$40	$477.9K
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…	5,750	$80	$442.4K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	290	$1,270	$372.2K
99234	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	3,520	$100	$355K

Showing 1–10 of 74

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

East Carolina University — 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

74 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.	308	330	6,130	$130	$2.7M
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.	215	320	6,160	$120	$2.1M
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	12	50	70	$1,220	$332.9K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	437	2,850	10,910	$10	$330.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	1	60	1,440	$110	$309.4K
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…	782	4,400	960	$60	$271.3K
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…	71	4,130	670	$50	$219.9K
59510	In this global service, the provider provides all of the antepartum care, admission to the hospital for delivery, delivery of the fetus and placenta via an abdominal incision, and inpatient and…	8	10	150	$1,150	$183.1K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2	160	420	$60	$183K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	93	510	480	$40	$166.3K

Showing 1–10 of 74

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
East Carolina University	NC	Internal Medicine Physician	$0	$53.7M
East Carolina University	NC	Pediatrics Physician	$0	$22.8M
East Carolina University	NC	Family Medicine Physician	$0	$9.5M
Kettering Independent Medical Group Inc	OH	Orthopaedic Surgery Physician	$0	$8.4M
Constantin Marcu	NC	Cardiovascular Disease Physician	$405.9K	$0
Rukmini Menon	NC	Neurology Physician	$390.4K	$0
Tobin Finizio	NC	Diagnostic Radiology Physician	$357.5K	$0
Zsuzsanna Therien	NC	Diagnostic Radiology Physician	$331.3K	$0
Michael Kachmann	OH	Neurological Surgery Physician	$313.8K	$0
Mackenzie Smith	NC	Family Medicine Physician	$310.3K	$0

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
Paradigm, Inc.	NC	Community/Behavioral Health Agency	$0	$37.8M
Better Connections, Inc.	NC	Community/Behavioral Health Agency	$0	$25.4M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$25M
Pitt County Memorial Hospital Inc	NC	Ambulance	$0	$15.6M
Pediatric Services Of America, LLC	NC	Nursing Care Agency	$0	$15.6M
Eastern Radiologists Inc	NC	Diagnostic Radiology Physician	$0	$14.3M
Greenville Pediatric Services, Inc	NC	Pediatrics Physician	$0	$10.9M
Health-pro Homecare Services, Inc.	NC	Home Health Agency	$0	$10M

East Carolina University — Billing Profile & Reimbursement Data

Sign up for East Carolina University — Billing Profile & Reimbursement Data policy alerts

East Carolina University — Billing Profile & Reimbursement Data

Sign up for East Carolina University — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References