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.

Cornelius F. Cathcart, Pediatrics,pa (NPI 1902991698)

Cornelius F. Cathcart, Pediatrics,pa is a pediatrics physician provider located in Henderson, North Carolina. This profile covers 0 Medicare and 68 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	Cornelius F. Cathcart, Pediatrics,pa
Address	451 Ruin Creek Rd
City	Henderson
State	NC
ZIP	27536
Taxonomy	Pediatrics Physician
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

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

68 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…	34,870	$60	$2.1M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	384,680	$10	$1.9M
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…	15,720	$90	$1.4M
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…	6,160	$90	$548.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,180	$90	$460.6K
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…	5,350	$90	$460.2K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	11,730	$40	$434K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	10,450	$40	$407.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	17,520	$20	$333K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,960	$90	$278K

Showing 1–10 of 68

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

Cornelius F. Cathcart, Pediatrics,pa — 7 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

68 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.	81	2,850	10,910	$10	$330.3K
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…	256	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…	97	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…	82	550	970	$90	$258.9K
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…	109	4,130	670	$50	$219.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	74	590	490	$90	$179.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	66	530	270	$90	$112.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	49	630	840	$30	$101.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	156	610	1,000	$10	$94.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	105	570	190	$70	$92.9K

Showing 1–10 of 68

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vance Family Medicine, PA	NC	Rural Health Clinic/Center	$0	$21.3M
Dlp Maria Parham Medical Center LLC	NC	General Acute Care Hospital	$0	$19.1M
Beyond Challenges Community Services LLC	NC	Preferred Provider Organization	$0	$10.7M
Vance Recovery, PC	NC	Methadone Clinic	$110.6K	$10.5M
Rhonda L Kearney, Dds, Ms, PLLC	NC	Pediatric Dentistry	$0	$7.8M
County Of Vance Office Of Treasurer	NC	Land Ambulance	$376.9K	$2M
Ashish Singh	NC	Critical Care Medicine (Internal Medicine) Physician	$176.6K	$236.9K
Mast Drug Co Inc	NC	Community/Retail Pharmacy	$308.3K	$5.9K
Tariq Abo-kamil	NC	Nephrology Physician	$156K	$0
Gary Smith	NC	Family Medicine Physician	$70.4K	$0

Cornelius F. Cathcart, Pediatrics,pa — Billing Profile & Reimbursement Data

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Cornelius F. Cathcart, Pediatrics,pa — 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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