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.

Senior Quality Care, Inc. (NPI 1992719991)

Field	Value
Entity Type	Organization
Organization	Senior Quality Care, Inc.
Address	633 S. Key St.
City	Pilot Mountain
State	NC
ZIP	27041
Taxonomy	Personal Care Attendant
NPI Enumerated	July 28, 2006

Payer Source	Total Paid
Medicaid	$9.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	64,880	$110	$7.4M
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	44,960	$50	$2.3M

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

Senior Quality Care, Inc. — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	46	400	15,030	$100	$3M
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	489	1,450	23,320	$50	$2.3M

Senior Quality Care, Inc. — Billing Profile & Reimbursement Data

Sign up for Senior Quality Care, Inc. — Billing Profile & Reimbursement Data policy alerts

Senior Quality Care, Inc. — Billing Profile & Reimbursement Data

Sign up for Senior Quality Care, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References