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.

Advance Behavioral Center, Inc. (NPI 1730310533)

Advance Behavioral Center, Inc. is a adult mental health clinic/center provider located in Sanford, North Carolina. This profile covers 0 Medicare and 15 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	Advance Behavioral Center, Inc.
Address	317 Chatham St
City	Sanford
State	NC
ZIP	27330
Taxonomy	Adult Mental Health Clinic/Center
NPI Enumerated	July 28, 2009

Payer Source	Total Paid
Medicaid	$8M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2022	Community-based wrap-around services, per diem	29,120	$210	$6.2M
H2015	Comprehensive community support services, per 15 minutes	5,460	$150	$834.6K
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…	4,900	$60	$294.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	2,380	$110	$261.5K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	650	$230	$147.1K
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…	1,770	$80	$136.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	770	$60	$46.8K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	330	$80	$26.1K
99203	The provider sees a new 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 provider…	210	$100	$21.7K
99204	The provider sees a new 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 provider…	90	$150	$13.8K

Showing 1–10 of 15

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

Advance Behavioral Center, Inc. — 0 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	23	220	3,330	$290	$3.3M
H2015	Comprehensive community support services, per 15 minutes	158	250	10,060	$130	$2.4M
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…	578	1,710	810	$80	$274.5K
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…	736	4,130	670	$50	$219.9K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	26	90	220	$220	$121K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	91	1,130	160	$80	$75.6K
99203	The provider sees a new 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 provider…	429	1,090	120	$60	$71.5K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	163	380	250	$80	$66.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	168	620	210	$50	$63.1K
99204	The provider sees a new 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 provider…	626	1,310	80	$90	$59.7K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Antonio S. Braithwaite Dds Mph PA	NC	Pediatric Dentistry	$0	$22.1M
Stevens Center	NC	Developmentally Disabled Services Day Training Agency	$0	$19M
Total Life Care Inc	NC	Home Health Agency	$0	$14.7M
Dlp Central Carolina Medical Center LLC	NC	General Acute Care Hospital	$0	$12M
Sanford Pediatrics, P.A.	NC	Pediatrics Physician	$0	$10.7M
Larry J. Moray, Dds, Ms, PA	NC	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$8.9M
Ashwani Sastry	NC	Vascular Surgery Physician	$1.3M	$0
Sreejit Nair	NC	Vascular Surgery Physician	$658K	$0
Mahmoud Atieh	NC	Interventional Cardiology Physician	$649.6K	$0
Lukas Jantac	NC	Cardiovascular Disease Physician	$383.7K	$0

Advance Behavioral Center, Inc. — Billing Profile & Reimbursement Data

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Advance Behavioral Center, 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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References