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.

Wake Specialty Physicians, LLC (NPI 1942440375)

Wake Specialty Physicians, LLC is a surgery physician provider located in Raleigh, North Carolina. This profile covers 0 Medicare and 126 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	Wake Specialty Physicians, LLC
Address	3000 New Bern Ave
City	Raleigh
State	NC
ZIP	27610
Taxonomy	Surgery Physician
NPI Enumerated	February 25, 2009

Payer Source	Total Paid
Medicaid	$14.8M
Medicare	$0

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

126 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	415,990	$10	$2.5M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	2,770	$660	$1.8M
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…	25,360	$40	$1.1M
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…	12,100	$90	$1.1M
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…	14,370	$70	$991.3K
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…	10,010	$90	$900.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,720	$90	$537.4K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	4,730	$90	$425.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	7,200	$60	$410.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	9,550	$40	$363K

Showing 1–10 of 126

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

Wake Specialty Physicians, LLC — 4 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

126 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.	196	330	6,130	$130	$2.7M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	15	20	2,430	$300	$1.5M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	10	20	3,950	$100	$740.3K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	3	30	50	$620	$410.2K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	10	20	2,270	$90	$369.8K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	25	40	1,080	$110	$365.2K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	74	2,850	10,910	$10	$330.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	23	60	1,440	$110	$309.4K
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…	297	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…	32	520	1,080	$80	$262.1K

Showing 1–10 of 126

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Siddhartha Rao	NC	Interventional Cardiology Physician	$944.7K	$0
Pavlo Netrebko	NC	Clinical Cardiac Electrophysiology Physician	$497.1K	$0
Rama Garimella	NC	Cardiovascular Disease Physician	$396K	$0
Rajesh Vakani	NC	Cardiovascular Disease Physician	$373.1K	$0
Pratik Desai	NC	Cardiovascular Disease Physician	$365.4K	$0
Dwijesh Patel	NC	Interventional Cardiology Physician	$361.6K	$0
Sunil Desai	NC	Cardiovascular Disease Physician	$298.3K	$0
Joshua Macomber	NC	Cardiovascular Disease Physician	$277.6K	$0
Marc Silver	NC	Clinical Cardiac Electrophysiology Physician	$266K	$0
Brian Go	NC	Interventional Cardiology Physician	$178.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wakemed	NC	General Acute Care Hospital	$0	$140.8M
Carolina Outreach, LLC	NC	Community/Behavioral Health Agency	$0	$38M
County Of Wake	NC	State or Local Public Health Clinic/Center	$0	$26.4M
Southlight Healthcare	NC	Community/Behavioral Health Agency	$124.4K	$24.4M
Wake Emergency Physicians PA	NC	Emergency Medicine Physician	$0	$24.3M
Surgical Center For Dental Professionals Of Nc LLC	NC	Ambulatory Surgical Clinic/Center	$0	$11M
Advance Community Health, Inc	NC	Federally Qualified Health Center (FQHC)	$0	$10.8M
Advance Community Health, Inc	NC	Federally Qualified Health Center (FQHC)	$0	$10.7M
Family First Personal Care	NC	In Home Supportive Care Agency	$0	$9.5M
Southeastern Healthcare Of North Carolina, Inc.	NC	Community/Behavioral Health Agency	$0	$8.2M

Wake Specialty Physicians, LLC — 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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