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.

Clinton Medical Clinic, Inc. (NPI 1780629154)

Clinton Medical Clinic, Inc. is a general practice physician provider located in Clinton, North Carolina. This profile covers 0 Medicare and 87 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	Clinton Medical Clinic, Inc.
Address	403 Fairview St
City	Clinton
State	NC
ZIP	28328
Taxonomy	General Practice Physician
NPI Enumerated	June 18, 2006

Payer Source	Total Paid
Medicaid	$17.3M
Medicare	$0

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

87 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…	78,450	$60	$4.5M
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…	35,600	$80	$2.8M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	424,110	$10	$2.5M
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…	11,560	$80	$959.2K
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…	10,650	$90	$926.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	9,290	$90	$836.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	13,470	$60	$794.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	16,380	$40	$638.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	29,800	$20	$566.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3,740	$100	$354.8K

Showing 1–10 of 87

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

Clinton Medical Clinic, Inc. — 12 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

87 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.	72	2,850	10,910	$10	$330.3K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	24	160	270	$10	$316.7K
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…	74	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…	36	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…	36	550	970	$90	$258.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	131	290	1,720	$10	$248.2K
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…	28	4,130	670	$50	$219.9K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	45	210	290	$10	$187K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	27	590	490	$90	$179.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	33	330	300	$10	$142.3K

Showing 1–10 of 87

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unc Physicians Network LLC	NC	General Practice Physician	$0	$47M
Jeffrey Jones	NC	Diagnostic Radiology Physician	$697.7K	$0
Mahmoud Atieh	NC	Interventional Cardiology Physician	$649.6K	$0
Teigha Randolph	NC	Internal Medicine Physician	$560.6K	$0
Sean Whalen	NY	Nuclear Medicine Physician	$555.5K	$0
Benjamin Atkeson	NC	Cardiovascular Disease Physician	$477.1K	$0
Nzeadibenma Uzochukwu	IL	Diagnostic Radiology Physician	$84K	$360.8K
Matthew Wagner	MD	Diagnostic Radiology Physician	$435.1K	$690
Brittany Grady	NC	Family Medicine Physician	$391K	$0
Lukas Jantac	NC	Cardiovascular Disease Physician	$383.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Speech And Language Rehabilitation Services, Inc.	NC	Speech-Language Pathologist	$0	$11.5M
Wp-clinton Health Holdings, LLC	NC	Adult Care Home Facility	$0	$10.5M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$9.9M
Sampson Regional Medical Center	NC	General Acute Care Hospital	$0	$9M
County Of Sampson	NC	Land Ambulance	$565.5K	$2.4M
Robert Reagan	NC	Urology Physician	$438.9K	$0
Alexandria Glass	NC	Dermatology Physician	$303.5K	$0
Gordon Mcdevitt	NC	Diagnostic Radiology Physician	$210.9K	$0
Arthur Apolinario	NC	Family Medicine Physician	$147.4K	$0
Jordan Wattenburger	NC	Family Nurse Practitioner	$129.2K	$0

Clinton Medical Clinic, Inc. — Billing Profile & Reimbursement Data

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Clinton Medical Clinic, 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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