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.

The Full Coverage Pdn Company (NPI 1801286232)

Field	Value
Entity Type	Organization
Organization	The Full Coverage Pdn Company
Address	8396 Six Forks Rd
City	Raleigh
State	NC
ZIP	27615
Taxonomy	Nursing Care Agency
NPI Enumerated	January 22, 2015

Payer Source	Total Paid
Medicaid	$41.2M
Medicare	$0

Key Findings

THE FULL COVERAGE PDN COMPANY is a Nursing Care Agency based in RALEIGH, NC with an NPI enumerated on 2015-01-22 (~11 years ago). Its billing footprint is almost entirely on Medicaid with Total Medicaid revenue reported as $41.2M and no Medicare revenue on file.

The provider’s Medicaid code mix is concentrated in intensive home-based nursing services: T1000 (Private duty / independent nursing service(s) - licensed, up to 15 minutes) is the clear operational focus, with supplemental billing for respite (T1005) and occasional supply billing for gloves (A4927). This pattern indicates the organization operates as a private duty nursing/PDN provider rather than an episodic Medicare skilled-home-health model.

Revenue concentration is extreme within its Medicaid portfolio: the precomputed top 3 Medicaid codes account for 100.0% of this provider’s total Medicaid revenue, and T1000 alone represents $39.9M (96.7% of Medicaid revenue). That concentration creates material dependence on a single service line for the provider’s entire Medicaid revenue stream.

Activity and reimbursement detail show very high volume for the dominant unit: T1000 recorded 78.1K claims with an average paid/claim of $510, while T1005 has 3K claims at $447 avg paid/claim and A4927 has 154 claims at $75 avg paid/claim. These figures point to a high-frequency, per-15-minute unit delivery model for nursing services with relatively stable per-unit payments reported.

State-level competitive standing on the dominant code is notable but not singular: T1000 ranks #7 of 72 providers in-state (92th percentile; typical, unremarkable volume for this code), indicating THE FULL COVERAGE PDN COMPANY is among the larger state providers for private-duty nursing but still operates in a reasonably populated competitive set. T1005 ranks #11 of 33 (69th percentile; typical, unremarkable volume for this code) and A4927 ranks #124 of 153 (18th percentile; typical, unremarkable volume for this code), showing limited activity in supply billing.

Payer mix is effectively single-payer: the provider reports no Medicare revenue and relies on Medicaid exclusively for the $41.2M in lifetime revenue on file. Analysts should treat this entity as Medicaid-dependent when assessing financial exposure and policy sensitivity.

Operational implications from the code mix include a likely focus on long-duration or frequent-contact care for Medicaid beneficiaries who require private-duty nursing and occasional respite services; the prominence of T1000 suggests staffing, scheduling, and billing systems optimized for repeated short-interval nursing units. The small contribution from A4927 indicates supplies are a negligible revenue line relative to clinical services.

Given the heavy reliance on T1000 (96.7% of Medicaid revenue), ongoing monitoring is warranted for changes in claim volume, per-claim reimbursement ($510 avg for T1000), and state program policy affecting private duty nursing. Any meaningful shift in T1000 utilization or rates would have an outsized impact on this provider’s Medicaid revenue profile.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	78,150	$510	$39.9M
T1005	Respite care services, up to 15 minutes	3,020	$450	$1.3M
A4927	Gloves, non-sterile, per 100	150	$80	$11.6K

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

The Full Coverage Pdn Company — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	7	70	35,680	$400	$16M
T1005	Respite care services, up to 15 minutes	11	30	1,190	$230	$849.2K
A4927	Gloves, non-sterile, per 100	124	150	1,490	$30	$389.7K

Nearby Providers

Other providers in the same ZIP code as The Full Coverage Pdn Company, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	NC	Home Health Agency	$0	$56.6M
Active Healthcare, Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$41.3M
Pediatric Services Of America, LLC	NC	Nursing Care Agency	$0	$32.4M
Key Autism Services Nc, LLC	NC	Community/Behavioral Health Agency	$0	$28.2M
Fernandez Community Center, LLC	NC	Community/Behavioral Health Agency	$0	$12.1M
Theodore F Mayerdds PA	NC	General Practice Dentistry	$0	$9.6M
Raleigh Pediatric Associates, PA	NC	Pediatrics Physician	$0	$7.8M
Morse Clinic Of North Raleigh, PC	NC	Methadone Clinic	$92.3K	$6.4M
Raleigh Nc Endoscopy Asc LLC	NC	Ambulatory Surgical Clinic/Center	$543.1K	$0
Kathryn Sabo	NC	Family Nurse Practitioner	$304.5K	$0

The Full Coverage Pdn Company — Billing Profile & Reimbursement Data

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The Full Coverage Pdn Company — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References