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 Health - Heritage Inc (NPI 1699757393)

East Carolina Health - Heritage Inc is a general acute care hospital provider located in Tarboro, North Carolina. This profile covers 0 Medicare and 108 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 Health - Heritage Inc
Address	111 Hospital Dr
City	Tarboro
State	NC
ZIP	27886
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 17, 2005

Payer Source	Total Paid
Medicaid	$12.9M
Medicare	$0

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

108 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	18,060	$120	$2.2M
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.	24,140	$80	$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.	10,060	$140	$1.4M
0225U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0225U for the…	2,630	$380	$1M
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.	1,220	$590	$722.8K
0241U	N/A	4,790	$150	$719K
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.	3,890	$170	$641K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	12,820	$30	$397.4K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	7,730	$50	$363.5K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	6,060	$60	$345.5K

Showing 1–10 of 108

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 Health - Heritage Inc — 0 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

108 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.	104	330	6,130	$130	$2.7M
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…	90	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.	77	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.	86	280	2,690	$130	$1.6M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	589	640	4,280	$60	$983.2K
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.	134	360	1,830	$40	$819.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	53	90	4,210	$30	$676.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	106	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.	117	190	560	$20	$609.8K
0241U	N/A	32	140	1,140	$150	$510.8K

Showing 1–10 of 108

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
Duplin General Hospital Incorporated	NC	General Acute Care Hospital	$0	$13.6M
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
Positive Generation In Christ, Incorporated	NC	Community/Behavioral Health Agency	$0	$16.5M
Positive Influences, Inc.	NC	Community/Behavioral Health Agency	$0	$16.4M
Homecare Management Corporation	NC	Developmentally Disabled Services Day Training Agency	$0	$13.7M
County Of Edgecombe Office Of Auditor	NC	Land Ambulance	$1M	$2.9M
Meridith Taylor	NC	Family Medicine Physician	$243.2K	$0
Stephen Kinard	NC	Foot & Ankle Surgery Podiatrist	$129.7K	$106.4K
Paul Woodard	NC	Internal Medicine Physician	$169.7K	$0
Karen Coward	NC	Family Medicine Physician	$123.5K	$0
Jeffrey Silver	NC	Pulmonary Disease Physician	$118.5K	$0
Manisha Tiwari	NC	Internal Medicine Physician	$93.1K	$0

East Carolina Health - Heritage Inc — Billing Profile & Reimbursement Data

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East Carolina Health - Heritage Inc — 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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