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.

Carolinas Medical Center (NPI 1528209681)

Carolinas Medical Center is a pediatrics physician provider located in Charlotte, North Carolina. This profile covers 0 Medicare and 22 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	Carolinas Medical Center
Address	1350 S Kings Dr
City	Charlotte
State	NC
ZIP	28207
Taxonomy	Pediatrics Physician
NPI Enumerated	March 18, 2009

Payer Source	Total Paid
Medicaid	$17.8M
Medicare	$0

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

22 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.	2,409,480	$10	$14.5M
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…	40,790	$50	$1.9M
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…	16,270	$70	$1.1M
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…	16,540	$10	$82.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,300	$20	$50.6K
96161	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient's caregiver, analyzes the results, assigns a score, and documents the findings. Use this code…	21,600	$1	$43.2K
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…	14,080	$1	$42.2K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	520	$70	$36.6K
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…	460	$70	$33.3K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	470	$60	$26.8K

Showing 1–10 of 22

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

Carolinas Medical Center — 6 of 22 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	5	2,850	10,910	$10	$330.3K
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…	246	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…	22	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…	25	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…	86	4,130	670	$50	$219.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	62	590	490	$90	$179.8K
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…	395	510	480	$40	$166.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	182	530	270	$90	$112.8K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	41	110	190	$70	$95.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	441	490	260	$40	$80.3K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Orthocarolina	NC	Orthopaedic Surgery Physician	$0	$12.3M
Inpatient Consultants Of North Carolina, PC	NC	Internal Medicine Physician	$0	$12.1M
Waveco LLC	NC	Ambulatory Surgical Clinic/Center	$1.6M	$0
Andrew Laster	NC	Rheumatology Physician	$1.5M	$0
Justin Favaro	NC	Hematology & Oncology Physician	$1.2M	$0
Nasfat Shehadeh	NC	Hematology & Oncology Physician	$700K	$0
Charlotte Gastroenterology & Hepatology, PLLC	NC	Ambulatory Surgical Clinic/Center	$407.5K	$90.2K
Omar Behery	NC	Orthopaedic Surgery Physician	$446.2K	$220
Anthony Kwon	NC	Orthopaedic Surgery Physician	$371.3K	$0
Amit Om	NC	Dermatology Physician	$334.7K	$0

Carolinas Medical Center — Billing Profile & Reimbursement Data

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Carolinas Medical Center — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carolinas Medical Center	NC	General Acute Care Hospital	$0	$178.2M
Carolinas Medical Center	NC	Surgical Critical Care Physician	$0	$52.9M
Carolinas Physicians Network Inc	NC	Psychologist	$0	$29.4M
Carolinas Medical Center	NC	Psychiatric Hospital Unit	$0	$20.6M
Carolinas Medical Center	NC	Ambulance	$0	$17M
Carolinas Medical Center	NC	General Practice Physician	$0	$16.6M
Carolinas Medical Center	NC	Child & Adolescent Psychiatry Physician	$0	$16.6M
Carolinas Medical Center	NC	Obstetrics & Gynecology Physician	$0	$11.8M
Carolinas Physicians Network Inc.	NC	Vascular Surgery Physician	$0	$8.9M
University Pediatrics	NC	Pediatrics Physician	$0	$8.1M