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 Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

Richard Carter (NPI 1639155575)

Field	Value
Entity Type	Individual
Organization	Richard Carter
Address	215 N Allison Ave
City	Barbourville
State	KY
ZIP	40906
Taxonomy	Family Medicine Physician
NPI Enumerated	December 22, 2005

Payer Source	Total Paid
Medicare	$10.1K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

7 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…	90	$60	$5.4K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	40	$50	$1.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	50	$30	$1.6K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	30	$20	$480
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	30	$20	$450
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	40	$10	$310
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	40	$1	$80

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Richard Carter — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0002	3	10	20	$50	$12.2K
99213	3,441	7,250	80	$50	$7.7K
36415	749	1,040	100	$10	$1.7K
87426	96	570	20	$30	$1.2K
87804	318	530	40	$20	$940
87880	181	560	20	$20	$490
81003	406	1,240	30	$1	$150

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Barbourville Family Health Center	KY	Rural Health Clinic/Center	$0	$7.6M
Kentucky Rural Health Information Technology Network, Inc.	KY	Primary Care Clinic/Center	$0	$5.7M
Harold Reedy	KY	Diagnostic Radiology Physician	$138.1K	$8.6K
Stuart Mack	KY	Physician Assistant	$1.4K	$0

Nearby Providers

Other providers in the same ZIP code as Richard Carter, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arh Mary Breckinridge Health Services, Inc.	KY	Critical Access Hospital	$0	$33.2M
Appalachian Restoration Project Inc.	KY	Substance Abuse Rehabilitation Facility	$0	$5M
Family Pride Counseling	KY	Community/Behavioral Health Agency	$0	$3.9M
Family Health Care Associates Of Barbourville Inc	KY	Rural Health Clinic/Center	$0	$3.5M
Knox County Ambulance Service	KY	Land Ambulance	$313.3K	$971.6K
Ashutosh Lohe	KY	Nephrology Physician	$209.2K	$0
Syed Hasni	KY	Nephrology Physician	$188.6K	$0
James West	KY	Family Medicine Physician	$42.4K	$0
Kellie Smith	KY	Family Nurse Practitioner	$11.7K	$0
Jerry Ward	KY	Clinical Social Worker	$1K	$2.4K

Richard Carter — Billing Profile & Reimbursement Data

Sign up for Richard Carter — Billing Profile & Reimbursement Data policy alerts

Richard Carter — Billing Profile & Reimbursement Data

Sign up for Richard Carter — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References