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 Wyoming for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wyoming 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. Wyoming (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.

Rock Springs Family Practice Inc (NPI 1023169778)

Rock Springs Family Practice Inc is a family medicine physician provider located in Rock Springs, Wyoming. This profile covers 0 Medicare and 10 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	Rock Springs Family Practice Inc
Address	1208 Hilltop Dr
City	Rock Springs
State	WY
ZIP	82901
Taxonomy	Family Medicine Physician
NPI Enumerated	January 16, 2007

Payer Source	Total Paid
Medicaid	$242.7K
Medicare	$0

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

10 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…	3,080	$50	$141.9K
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…	1,270	$40	$51.9K
99058	The provider renders emergency services to a patient in the provider’s office during regular office hours without an appointment and ahead of other scheduled patients.	1,940	$20	$44.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	150	$10	$1.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	80	$10	$1.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	30	$40	$1.2K
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	$40	$430
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	30	$1	$30
90658	This code represents a trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	20	$0	$0
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	30	$0	$0

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wyoming providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wyoming Distribution

Rock Springs Family Practice Inc — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	64	220	400	$50	$79.3K
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…	38	260	420	$30	$67.2K
99058	The provider renders emergency services to a patient in the provider’s office during regular office hours without an appointment and ahead of other scheduled patients.	1	10	70	$20	$15.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	50	70	70	$20	$10.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	14	20	140	$20	$9.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	27	50	100	$10	$5.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	16	40	80	$10	$3.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	41	50	140	$1	$820
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	50	60	100	$1	$580
90658	This code represents a trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	5	10	30	$0	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lsw, LLC	WY	Developmentally Disabled Services Day Training Agency	$0	$11.6M
Able Hands	WY	Developmentally Disabled Services Day Training Agency	$0	$9.6M
Sweetwater Pediatrics P.C.	WY	Primary Care Clinic/Center	$0	$2M
Pain Care Center, LLC	WY	Pain Medicine (Anesthesiology) Physician	$0	$1.6M
Southwest Counseling Service	WY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.5M
Qrc LLC	WY	Case Management Agency	$0	$1.4M
University Of Utah Adult Services	WY	Emergency Medicine Physician	$0	$1.2M
Lcr Dental Rock Springs LLC	WY	Dentist	$0	$1.1M
Memorial Hospital Of Sweetwater County	WY	Internal Medicine Physician	$0	$1.1M
Aai Services LLC	WY	Case Management Agency	$0	$971.4K

Rock Springs Family Practice Inc — Billing Profile & Reimbursement Data

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Rock Springs Family Practice 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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