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.

Carteret Clinic For Adolescents And Children (NPI 1609833490)

Carteret Clinic For Adolescents And Children is a pediatrics physician provider located in Morehead City, North Carolina. This profile covers 0 Medicare and 59 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	Carteret Clinic For Adolescents And Children
Address	3510 John Platt Dr
City	Morehead City
State	NC
ZIP	28557
Taxonomy	Pediatrics Physician
NPI Enumerated	April 27, 2006

Payer Source	Total Paid
Medicaid	$8.7M
Medicare	$0

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

59 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	41,720	$60	$2.4M
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…	16,250	$90	$1.4M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	218,210	$10	$1.3M
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…	5,950	$80	$493.5K
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…	5,360	$80	$433.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,910	$90	$427.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	17,090	$20	$341.9K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2,520	$140	$340.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	8,930	$40	$330.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,420	$100	$229.9K

Showing 1–10 of 59

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

Carteret Clinic For Adolescents And Children — 2 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

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	20	90	250	$110	$352.3K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	165	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…	464	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…	247	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…	95	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…	86	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…	84	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.	79	590	490	$90	$179.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	91	530	270	$90	$112.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	64	630	840	$30	$101.2K

Showing 1–10 of 59

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edwards Health Care Services, Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$35.2M
Maxim Healthcare Services, Inc.	NC	Home Health Agency	$0	$28.8M
Pathways Human Services Of North Carolina, LLC	NC	Community/Behavioral Health Agency	$0	$10.3M
Morehead City Treatment Center, LLC	NC	Community/Behavioral Health Agency	$121.4K	$3.9M
Friendly Medical Transportation LLC	NC	Land Ambulance	$825.8K	$2.9M
Center Of Morehead City, LLC	NC	Ambulatory Surgical Clinic/Center	$888.8K	$0
Town Of Morehead City	NC	Land Ambulance	$441.5K	$387.2K
Mary Lawrence	NC	Endocrinology, Diabetes & Metabolism Physician	$581.6K	$0
John Gould	NC	Cardiovascular Disease Physician	$529.4K	$0
Garlon Campbell	NC	Pain Medicine (Anesthesiology) Physician	$495.6K	$0

Carteret Clinic For Adolescents And Children — Billing Profile & Reimbursement Data

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Carteret Clinic For Adolescents And Children — 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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